Tag Archives: prostate cancer

Today I had another chance to enjoy a trip to Stoke Mandeville hospital for my third PSA-level check since my radical prostatectomy. Coincidentally, it is one year to the day since I dressed (briefly) in a theatre gown and was ushered into the wings of the operating theatre awaiting my entrance to go under the knife. Actually, this should have been my fourth post-operative check but holidays [vacations in Amerispeak] got in the way somewhat. Well, one shouldn’t let medical issues disturb having a good time too much, eh?

Carol cleverly avoided the normal Stoke Mandeville parking nightmare by kicking me out of the car in the near vicinity – at least she came to a halt before doing so – and then smartly dashing off to do some planning for her mum’s approaching 90th birthday bash.

I walked the short distance to outpatients reception to check in, then wandered along to the waiting room. I had hardly sat down and begun reading one of the traditionally out of date magazines before I was called in to see the consultant. Odd! This is the first time my appointment has ever been on-time.

PSA-level = zero.

I have to return for another check in March but, if that is still zero, they will let my GP carry out the further tests. Actually, I had been expecting that to happen this time; I think it’s normal after one year. My suspicion is that the consultant saw just three test results, which are normally at 3-monthly intervals, and didn’t realize that my year was, in fact, up. Still, no worries, I don’t have much else planned for March. I walked back into town to meet Carol.

It was a curious hospital trip: no stressful searching for a parking space and no one hour wait staring at paint flaking off the walls.

Excellent news, happy anniversary.

I must have been having too much fun over the summer because I just realized that it’s been a long time since I wrote anything about my recovery from my radical prostatectomy. My last entry seems to have been April 16th. That’ll never do – time to correct my oversight and keep awareness high, especially as we approach Movember again. To cut a long story short, my news is all good.

Following our spring jaunt around France for a disgustingly decadent eight weeks, I went to the consultant’s clinic for my second postoperative PSA level check. Now, before the result, here’s a brief aside. Another guy  breezed in, sat beside me and, not knowing me from Adam or my current situation, starting blathering on about how wonderful his PSA results were and chirpily finishing with, “oh yes, happy days”. I could have been sitting there with a terminal condition – he didn’t know. What a complete plonker! Fortunately I wasn’t; my second result was the same as the first check, as near to zero as they can measure (0.05).

We’ve just returned from France part deux, hence my rather elongated period of silence. This trip was a mere six weeks. About a week into the trip, since my i-Pads seemed to be staying largely dry recently, I bit the bullet and decided to try a day “going commando” in a manner of speaking. I was probably also spurred on by the fact that 30°C weather gets a little warm wearing an i-Pad, so lets have it off! I wouldn’t say that I feel 100% secure but I haven’t worn one since and I haven’t yet disgraced myself (my fingers are very firmly crossed).

Ditching the i-Pads after wearing them for nine months required a leap of faith. I had tried returning from the shower block without one – i-Pads and shower cubicles do not mix well – on the earlier French trip and found that I got caught out once or twice so it made me a little leery and I had to get over my lack of confidence.

So, there it is, everything is going in the right direction. I’ll be having my next blood test, coincidentally, on the one year anniversary of my operation, December 2nd.

Today it is exactly four calendar months since the removal of my post-prostatectomy catheter, the start of Mr. Leaky, so I thought another progress bulletin was in order.

There’s a couple of things to point out about this return to continence process, assuming I haven’t already done so. [Ed: A senior moment, eh?] The first is that the level of security can vary quite markedly from day to day. I have frequently been somewhat disappointed having suffered a less secure day following what seemed like a relatively very good day. This phenomenon is something I’ve tagged Inconsistent Incontinence, or II (eye-eye) for short. I’ve no idea why it happens, but it does. This is one of the reasons it is important to take an average view and look back a week or two to gauge progress.

A second feature is that, as progress is made, it gets quite difficult to assess further progress. In the earlier stages of recovery it is quite obvious, for example, that you can now get out to the driveway and into the car securely whereas a little while ago, down the hall to the kitchen was one’s limit. Even judging the difference between walking, say, a quarter mile compared to half a mile are quite easy to gauge. Once over a mile, though, progress gets trickier (unless you resort to a pedometer or GPS solution). During our recent two weeks sauntering around the New Forest, I felt much the same as I had for about the previous month: get about a mile, then start noticing that old I’m-about-to-leak sensation.

This week, however, has provided a couple of good milestones – another good reason for a progress update. I joined our local U3A walking group on Tuesday for a 5½ mile walk around some very pleasant woodland and countryside in our vicinity. It’s only two weeks since we were in the New Forest but I felt, really, very secure. I very nearly made it as far as the 3-mile post, actually, 2.8 miles (I admit it, I used the GPS solution), before any lack of security crept in, and then it was very slight. I was/am delighted.

I had even stressed myself a day earlier by voluntarily lifting and re-laying several heavy patio slabs to correct a slight subsidence. A couple of months ago any work of a heavy nature would certainly have caused a bit of a leak but I seemed to cope admirably.

Remembering the first feature, II, I’m resisting getting carried away. I’m certainly not ready to ditch the i-Pad Manos just yet but I am very positive about recent progress. Cycling is no problem at all, except that I sometimes think that I suffer a slightly increased weakness as an after-effect of it, and if I can indulge in 5-mile or more walks without too much concern then, in practical terms, life is not too far from normal. I can indulge in the pastimes I enjoy.

We’ve booked the ferry for France ready for our spring migration. Yeah!

Following my radical prostatectomy last December, Friday was my second follow-up appointment with the medical team and the first for my post-operative PSA level checks. The hospital was typically manic with the waiting areas full to overflowing and my appointment was clearly going to be late happening.

As well as Stoke Mandeville hospital, Aylesbury boasts one of Her Majesty’s prisons. As we were waiting patiently, in walked a pair of prison officers, one of whom had one of Her Majesty’s prisoners attached to him with handcuffs. The trio sat right in front of us which, rightly or wrongly, I must say made me a little apprehensive. Carol noticed that the unattached prison officer was browsing a skiing brochure, which, in front of one incarcerated, we thought might be verging on the mentally cruel, even though we knew not what he was “in for”. Sniff of the free world, albeit for a medical problem, and a ski brochure being waved under your nose.

Our wait turned out to be about 45 minutes but was well worthwhile; I couldn’t have hoped for better news – my PSA reading was 0.05 which, the surgeon said, was effectively zero. Apparently, just as with temperature, with PSA absolute zero never happens. Everyone was happy.

Naturally, we also discussed my continence which, though not yet fully restored, seems to continue to improve. Last week I felt confident enough to resume accompanying our local walking group on a 4½ mile slither and slide through some very muddy local countryside. Dawkins, we’ve had a lot of rain lately! Though I didn’t stay completely dry on the inside, I ended up considerably less damp than the ground was on the outside. I thought that walking might be exercise that would benefit my recovery but it seem not – it exercises the wrong muscles. I was regaled to continue my pelvic floor (a.k.a. Kegel) exercises. So, ladies, I’m still with you!

On Saturday evening and Sunday morning I had another brush with a recovery process. Last week I installed Windows 7 Service pack 1 on what is supposed to be becoming my main laptop. Service Pack 1 can be a very large download (80 – 900Mb) and update, especially if you don’t keep applying updates piecemeal as they are released. I do and the process downloaded a mere 87Mb but still took 58 minutes to complete, end to end, though it must be said that we suffer from a particularly slow broadband connection (~1.3Mbs), being a long way from our exchange.

All appeared to be well until Saturday evening. Having closed the lid to instigate a hibernation, when I re-started the machine I was greeted with the unwelcome message that Windows had detected errors when starting and offered me the choice of letting it attempt to recover (recommended) or just starting normally. I’d had nothing critical “in flight” to lose so I tried starting normally. Back came the same unwelcome screen. Each time I selected “start normally”, back came that screen.

OK, I thought, clearly I have to pick the “attempt to recover” option. Quick as lightening, some people. It looked more promising; a blue-sky-with-vapour-trails Windows backdrop appeared together with a mouse pointer and nothing else. For a brief while the cyclone “doing something” symbol appeared beside the mouse pointer, then disappeared and nothing further seemed to be happening. I had recovery disks but couldn’t get into Windows or Dell software to do anything with them. I hit the big OFF button and tried booting from them but ended up in the same place. I didn’t actually know if they were bootable, after all. Defeated, I hit the big OFF button again and went to bed.

In the cold light of Sunday morning, I wondered if the blue-sky-with-vapour-trails Windows backdrop might be doing something unannounced behind the scenes, like downloading stuff. I kicked it of again and left it. After about 15 minutes, sure enough, it claimed to be “scanning for errors”. Sometime later the screen changed to a more hopeful “attempting repairs” and a blue block began tromping its way repetitively across a progress bar on the screen. That was six hours ago; the blue is still tromping.

There are <Prev>, <Next> and <Cancel> buttons at the bottom of the screen. Only <Cancel> is active, <Prev> and <Next> are greyed out. I thought I might as well give up and try a Dell “System Restore”. I clicked the <Cancel> button.

The current repair operation cannot be cancelled. <OK>

… it said, wittily. What’s with the <Cancel> button, then?

Arghh

So, do I just leave it running? I’m not convinced that it’s actually doing anything. Carol found someone reporting that their Windows 7 repair had been running for 26 hours and was still going. Yikes! This stupid Dell Inspiron doesn’t even have a hard drive light such as is useful in indicating activity. All I can hear is the fan. [SCREAM!]

The 45 minute wait at the hospital was much more rewarding.

[This posting made possible by my old laptop now running Ubuntu.]

Considering the fact that I was born in February, I really should be used to it being a short month by now. I’m not, though; I never seem to be prepared for March to start. Slow learning curve I guess. So, here we are at the last day of February and it’s approaching three months since my radical prostatectomy. That makes it time to begin a year of 3-monthly follow-up blood tests for PSA. It is apparently necessary to wait three months after the operation to allow all existing PSA to get flushed from the system. If, as is hoped, all those nasty prostate cells have been successfully removed, my PSA level should drop to pretty much zero. This morning at 8:10 AM, I visited our practice nurse to get the blood sample taken and sent to the hospital. I should be given the results this Friday afternoon at my second follow-up meeting with the urology nurse. Fingers firmly crossed!

I’ve also agreed to take part in a UK Genetic Prostate Cancer Study being performed by the ICR (Institute of Cancer Research). That involved a questionnaire about my relatives, already completed, and two more samples of blood which our obliging practice nurse drew at the same time as the PSA sample to save on the holes.

This weekend was definitely my most active yet. We are both getting stir-crazy as a result of our dull winter but, since Sunday morning was unusually sunny, Carol decided to walk into town, a distance of about two miles, for a little retail therapy. I rashly chose to adopt a kill-or-cure approach and joined her for the 4-mile round trip wander. Brave or foolhardy, I knew not. Though not entirely leak-free, I did make it without the damage being disturbing. Obviously I’d love to remain entirely dry but at least it seems that I’m beginning to be able to do the things I enjoy most, even if with a little remaining apprehension.

The main reason for the retail therapy trip was to purchase an SDHC memory card for the little Nikon Coolpix camera that came with the digiscoping kit purchased on Saturday. The camera had a small amount of “on-board” memory (32Mb, I think) but a card would really be needed once we started digiscoping uncooperative wildlife. As I found out with my first attempts, catching a reasonable shot, given the inherent slight delay combined with jittery targets, is largely a matter of luck. You really need to press the shutter a lot and discard the 90% of the shots that missed. For a massive £4, we snagged a 4Gb SDHC card that would enable us to press the shutter about 350 times.

We got back just before the heavens opened. [Ed: that’s 2½ days of sun this month.]

In a desperate attempt to find a saving grace for naff weather, I’ll suggest that it does tend to increase the bird activity in our garden. Today, now armed with a memory card as well as a shiny new digiscoping kit, I tried playing with my new acquisition again.

I don’t really like photographs of birds on feeders. I do occasionally take such shots to document what species visit us but I wouldn’t use them as anything approaching artistic. Today, however, I noticed that some of our feathered friends, mostly Great Tits (Parus major), were using the bare branches of one of Carol’s acers as a staging post before raiding our peanut feeder. The occasional Blue Tit (Parus caeruleus) alighted, too, but all attempts to snag one of them were in my 90% discards, unfortunately. I did, however, manage to beat the odds when a Robin (Erithacus rubecla) perched briefly allowing me to get off two shots, one of which was perfectly OK. The acer makes for a much more natural-looking setting than a feeder.

Now, I wonder how I can persuade our local Long-tailed Tits (Aegithalos caudatus) to use the acer as well?

I don’t think I can remember such a dull, grey winter as this. Since our early winter snows over the Christmas period, when we did at least have some cold, crisp, blue sky days, we seem to have had very little other than dank, dull, grey overcast days. Judging by the sodden nature of the ground, many of these days have also produced rain.

I have been somewhat trapped, certainly psychologically, because I haven’t been able to walk any great distance given my recent continence issue courtesy of the operation. So, whilst I might not like the weather we’ve been having, other than the psychological impact of not wanting to be stuck in this climate, it hasn’t actually been that restrictive for me.

For Carol, it’s been a different issue. I made it quite clear that she should not be trapped just because I was restricted but, as healthy as she is, the weather has just not been conducive to cycling, which we both enjoy. Cycling in inclement weather is not enjoyable, in our view. Walking in less than clement weather may be less dangerous than cycling but the weather’s been so dull that it hasn’t exactly enticed her out for walks, either.

Today was no exception; it wasn’t actually raining, unlike yesterday, but it was very dull and dismal. The frustration and lack of exercise was too much and the dam broke. Carol announced that she was going to walk into town, a distance of two miles, run a few errands and wander back. I felt jealous. “Come with me”, she said. Gulp! After a quick internal conflict of wanting to get out and worrying about leaking, I thought I’d try going and see how far I could get, accompanied by my trusty emergency stool/walking stick. I got dressed up.

As luck would have it, as we were leaving so was our neighbour, Paul. Together the three of us sauntered out in the general direction of town. Paul was intending to do a loop through a tree-lined path behind another development, a distance of about a mile or so, which sounded like a reasonable target for my first outing. And so it was – Carol strode off into town and we cut off through the trees. Apart from anything else, Paul’s company was a suitable distraction and acted as moral support taking my mind of any self doubt.

There were times when I didn’t feel exactly “secure” but I got back largely unsullied. I was thinking about things other than taking my trusty Garmin to measure our distance but I think it was a little over a mile (having measure it on Google Earth.

Result!!

Next significant event approaching: first post-operative blood test on Monday (28th Feb) with results expected on the following Friday (4th Mar).

The healing process related to the expected period of incontinence following a radical prostatectomy is a very strange one. I freely confess that I do not understand the mechanism(s) involved. Given that, during the two weeks immediately following my operation, my bladder’s sphincter muscle was clamped around a catheter pipe the diameter of which approached that of an HB pencil, I can easily see why there would be a (hopefully) temporary loss of continence but I don’t comprehend the restoration process.

Were I attempting to approach this medical issue logically, I would have thought that once the sphincter “remembered” how to close fully following its catheterial [Ed: new word coined] disturbance, that would be it – continence restored. I’d have been wrong.

Any movement towards the restoration of normality is very gradual. The process is so gradual that I haven’t noticed any change on a day to day basis. Actually, to be more accurate, I haven’t noticed improvement on a day to day basis. There have been days, though happily only about two or three, when I’ve noticed a deterioration giving me the unhappy feeling that my condition had regressed somewhat. Such days were low points mentally and it was difficult to remain positive. These didn’t last, though. I could attempt to blame alcohol which, if I remember my Hitchhiker’s Guide to the Galaxy correctly, is an effective muscle relaxant.

No, to detect an improvement it is necessary to think back one or two weeks.

The process began, immediately after having been sent home sans catheter, by my leaking whenever I was standing up. I’d leak my way to the loo. Certainly any jobs around the house, such as coffee making, had to be performed from the security of a bar stool.

The first noticeable milestone – well, yardstone [Ed: there’s another new word] – was managing to get to the loo, a distance of about 20ft/4m, without leaking. Getting out to the car, about twice that distance, was not possible without “a little accident”.

The next stage was noticing getting downstairs to the kitchen in the mornings, apparently cleanly, and that I now could make it to the car. As long as I didn’t overdo it, I could now stand for some of the coffee making process before having hurriedly to resume my perch on the bar stool.

Washing up is nobody’s idea of fun but, when hadn’t been able to do it, realizing that I now could stand at the sink and complete a small pile of washing up without my bar stool safety net was quite a thrill. “Yikes, I couldn’t have done that a week ago”, is the kind of phrase that spins through the mind.

Monday last week was one of those mercifully infrequent low days that I mentioned; having been making progress, I suddenly seemed to be leaking at the drop of a hat again, relatively. I’ve never regarded shopping for anything other than food and booze as an exciting pastime but, later that week, I had recovered from my bad day and found that I made it around IKEA with little in the way of trouble. It may not be a hike out in the open air but it’s a significant distance around that megastore. I was very pleased. (There is a section at the end of the tour selling Swedish foods so maybe that lessened the shock of shopping.)

Earlier this week Carol suggested a visit to our local Stockgrove Country Park. Gulp! “OK, I’ll take my portable seat and see how things go.” I’m delighted to say that they went surprisingly well. I had my seat but didn’t need to deploy it. I felt a little “insecure” once or twice but essentially made it from the car park, down to and around the lake and back. Joy!

Yesterday was something of a rarity: a pleasant day in February. Few people regard washing a car as fun and I haven’t been able to entertain the thought since I went into hospital on 1st December, 2010. I couldn’t resist it yesterday, though; I was feeling reasonably secure and the draw of being out in some sunshine doing something useful was too much to resist. I even went on to clear up some leaves around the garden. Gardening – arghh!

So, here I am eight weeks downstream and what seems to improve, and improve very gradually, is the length of time/distance that control can be maintained. I’m also happy to note that the control is not now a case of clamping the ol’ pelvic floor/Kegel muscles though, if I do feel a little insecurity setting in, a quick clench often seems to sort it out. Why this process should be so gradual, though, I don’t know.

I suspect that, at some time, I  may arrive at a point where I can go for a certain length walk but that I’ll then be able to keep going and not hit some invisible limit. Hopefully, the sphincter will not suddenly decide that it’s had enough and take a rest. When I am able to complete, say, a five mile walk, I’ll be overjoyed. At that point, I’ll be able to do pretty much everything that’s important to my lifestyle.

As any regular readers will have noticed from my recent posts, it really isn’t possible to talk about the after-effects of a radical prostatectomy without completely burying one’s embarrassment. Fortunately, I don’t mind talking frankly and openly with my heart on my sleeve. I found the actual operation to be a doddle, for me at least – let’s face it, I was getting four hours of quality sleep – if not for the medical team. The catheter required afterwards to enable my joins to heal was uncomfortable but necessary for a mere two weeks. By far the most inconvenient factor, and I choose my words carefully, is the resultant incontinence which lasts months and is generally more restrictive. I look upon the incontinence as training for old age which, with luck, we’ll all attain.

OK, since much of my recent life has revolved around the obtaining and wearing of incontinence pads, I thought it might be instructive to put a little more detail on them. I can hear the cries of “too much information” now. Forge on, brave souls!

So, incontinence pads: let’s call them i-Pads for short. After all, typing “incontinence pads” all the time gets tiresome. I was discharged from hospital with a meagre supply of humongous i-Pads which you can see on the right of the photo. These were my generation one i-Pads and, as you might be able to imagine, the gen one i-Pad was not terribly portable. Just look at the size of it!

Fortunately, after only a week or so I able to upgrade to the generation two i-Pad which is in the centre of the picture. Though smaller, it is much less stylish, I think you’ll agree. The gen two i-Pad was decidedly an emergency security release. It was also, I suspect, designed largely with ladies in mind. I say this based upon partly its shape (shape?) but mostly on the fact that it was delivered in fetching pink packaging. Target audience aside, the gen two i-Pad was considerably more portable than gen one and served me well for several weeks. What does that tell you?

Finally, despite initial release difficulties at the supplier, I finally procured the much sought after generation three i-Pad seen far left in the photo. As you can tell from the attractive contours, this is very much aimed at a male audience – it must be an i-Pad mano – and is considerably more portable. Furthermore, allied improvements meant that, whereas the original gen one i-Pad had a capacity of a mere 12 hours, the smaller and lighter gen three i-Pad is capable of providing a full 24 hours of capacity. Excellent!

Naturally, since all these i-Pads are supposedly portable, a carrying case or skin is required. A couple of typical, suitable cases are shown in the picture on the left. As you can see, these i-Pad cases are available in a variety of colour ways to suit a variety of personal preferences. These are two of the more colourful examples but, for the less adventurous, they are also available in plain grey, white or black.

Style-wise there is much less choice – suitable choice, at least. This is because there is much less room for manoeuvre regarding shape since anything too loose would leave, well, far too much room to manoeuvre – if you see what I mean. The i-Pad needs to fit snugly in its case to afford maximum protection. One really doesn’t want to arrive at a destination only to discover that one’s i-Pad has fallen out. Trust me on this.

All generations of the i-Pad have featured touch-stream technology. Their chief raison d’être is, of course, to make contact with my stream and absorb it.

The same cannot be said for pull-down features. I this regard, both the gen one and gen two i-Pads left a lot to be desired. Neither was equipped with a mechanism to fasten them securely in their carrying case resulting in a loss of service occasionally when the case was pulled down without due care. Fortunately, we engineered a plug-in of our own to fix this bug on site. The plug-in came in the form of a safety-pin and pull down features were thus retrofitted. The gen three i-Pad, on the other hand, has tacky strips to secure it. Lesson learned, clearly.

It is well documented that one of the side effects of uninstalling the prostate and installing i-Pads is the disabling of erectile functionality. Hopefully this will be a temporary situation but I’ll have to wait a considerable time before knowing whether pop-up features can be developed.

Startling admission: I’ve never been a sports fan. [Ed: No, really!?] My problem is not just a lack of interest, it’s a dislike that encompasses not only watching sport but also, indeed mainly, partaking in sport.

By “sport”, I’m referring to all those traditional team games involving large expanses of grass and balls of varying shapes, sizes and hardness being kicked or knocked about by two opposing groups of tribal men on a war footing. Most uncivilized and extremely dull! It’s not just that I get bored witless by messing about with a ball but, In England at least, the aforementioned large expanse of grass is usually very wet, frequently muddy and often cold, even to the point of being frozen. I had absolutely no interest in being made to sprawl headlong on cold, muddy turf subsequently to have my hands trampled upon by several sets of rugby boot studs setting off in pursuit of the ball I had just dropped. Hateful!

I’ve always had the same approach to sport, especially at school. Wednesday afternoon was sports afternoon and I would be made to choose between the three abhorrent evils of rugby (stupidly shaped ball), hockey (that’s field hockey to the Amerispeakers – very hard ball) and cross-country running (stultifying, lung-bursting purgatory). All very character-building, I’m sure, but I’d rather have been exercising my brain in a triple maths period. (That’s math, to the Amerispeakers.)

A sick note at school on Wednesdays was like gold dust but was a rare item: “John can’t play rugby today because his gout has flared up again … signed, Mum”, kind of thing. [Ed: maybe she should have kept you off the port.] The traditional schoolboy ruse for getting out of sports afternoon was, of course, to forget one’s kit. This was naturally far too obvious and carried absolutely no weight whatsoever with the irritating sports masters, all of whom remained steadfastly convinced of sport’s beneficial qualities and who would kit out the unfortunate offender with various bits of ill-fitting, abandoned clothing from the school’s lost property collection. Thank you, sir!

Summer sport was a little less hateful ‘cos it was generally warmer though, in England, not necessarily drier. Beyond all our so-called playing fields, now marked out for cricket etc., my school was fortunate enough to have its own open-air swimming pool. The school must have been pretty well-to-do, I imagine. Beyond the pool, we even had a 25-yard rifle range complete with supply of .22 calibre rifles but that’s another story. Anyway, on one occasion, I had arrived at school expecting a gym lesson (yukko!) but was somewhat relieved when, instead, we were marched off to the swimming pool. (Don’t faint – I quite enjoyed swimming in those days.) Relieved, that is, except for the fact that I had no swimming trunks with me. The master made me strip off anyway and dive in naked, finally drying myself on my gym T-shirt (apparently I had no towel either). I should point out at this point that I attended a single-sex school: Watford Grammar School for Boys.

[Aside. Across town was was our single-sex “sister” school, Watford Grammar School for Girls. One day, due to their own facilities being repaired or otherwise out of commission, a group of the girls had been offered the use our swimming pool. We had been forewarned of this planned invasion of bathing belles and told to keep well clear. Naturally, to a bunch of sex-starved teenage boys whose testosterone was kicking in, a group of teenage girls and an open-air changing room was far too tantalizing a subject. Being on the far side of the playing fields, however, the distance to our forbidden fruit was something of a problem though nothing that couldn’t be addressed by a few sets of binoculars smuggled in using briefcases. ]

Stick with me, I’m getting there…

I don’t recall the term “skinny-dipping” in those halcyon days but my point is this: I found the experience of swimming unencumbered by clothing very liberating and most enjoyable.

Likewise, sleeping; other than in hospital where decorum dictates their use, I can’t remember the last time I slept in pyjamas. I suppose night attire of one form or another would maintain one’s modesty if the need arose to escape from a burning building or to give chase to a burglar (whereupon, with our crazy laws, the violated house-owner and pursuer would risk being arrested for using excessive force against a criminal) but tossing and turning in bed wearing any form of clothing simply ties you up in knots as the material gets twisted about the torso. Most uncomfortable! Much better to be naked when you can have a good ol’ scratch and get sorted.

The need to wear continence pads in the post-catheter-removal period following my radical prostatectomy, also requires that I wear close-fitting underwear 24 hours a day to hold my pad in place. Other than brief respites to take a shower, I’m now feeling constantly bundled up and constrained. It’s like wearing a straight-jacket. I’ve been in tight-fitting underpants (not the same pair, don’t panic) with my form-enhancing padding for over five weeks. I’m definitely getting to the point where I’d kill to be able to sleep as nature intended. I want to be able to scratch and squirm against the sheets. Darwin, that would be wonderful!

In the same vein, for the last few years I’ve begun to dislike wearing socks. Even in northern Europe the summers are normally warm enough to make socks unnecessary. When travelling around France for weeks on end, I would originally live mostly in sandals, definitely without socks. More recently, I fell in love with Crocs as my general camping footwear of choice, again without socks. I’d pack trainers and a few pairs of socks/liners (I detest trainers without any lining) as an emergency supply against unexpected inclement weather but would generally manage to avoid using them; the socks would be returned clean and unused. At the end of a summer, after several months of basically bare feet, I grew to resent once again having to don socks against the autumnal chill. I much preferred bare feet. Thinking about it, my mother always said she enjoyed having bare feet, too – nature or nurture?

I’m certainly a naturalist but maybe I’m becoming a naturist as well. In France, opposite one of our favoured campsites there is another which is a naturist campsite and is, a little worryingly, open all year.

Now there’s a thought.

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.