Friday 11 August 2023

So what''s it like having a RARP Radical Prosatectomy? - Rog T's cancer blog

 So here I am, back at home, having a cup of tea with a cathetar in and a very sore midriff. Excuse the spelling, which may well be even worse than usual. It's 2pm on Friday afternoon, I've just taken 2 paracetamol and I thought that as a diligent blogger, I really should share what this was like, just in case anyone was wondering. 

On Wednesday morning I got up at 5am. A quick swig of water (nothing else allowed). A quick shower and then off to Mill Hill Broadway for the 5.47am train. It was a glorious morning, as my Dad would always say "a fine day for a hanging", when the sun shone but he had to do something he really wasn't looking forward to. My destinatation was the London Bridge Hospital at the Guys Cancer Centre. I had to change trains at Blackfriars, which is always a station that I enjoy visiting just for the views of London.

I used to see this on a daily basis, now it is a rare treat. I arrived at the Guys hospital 20 minutes earlier than my 7am admission time.

I was ushered up to the 12th floor (I think - my brain is a bit fogged due to the residual effects of the anaesthetic). I was ushered into my room by a porter and put the telly on. A nurse came around, checked all of my vital statistics, asked my name and date of birth ( A process repeated ad infinitum over the next two hours). A nice red wristband was attached to my wrist. We had a brief discussion about the procedure and I signed a few consent forms. Just after 8am, Professor Christopher Eden, who was performing the procedure came in. He explained what he was going to do and asked me if I wanted to change my mind. I informed him that I wanted him to get on with it. He explained the intricasies of the RARP Radical Prostatectomy with Neurosafe procedure performed by a DaVinci robot, which is used to ensure that all of the cancerous tissue is removed, with the minimal damage to the nerve bundles in the prostate area. This treatment is not available on the NHS to the best of my knowledge. It gives men the best possible chance of preserving erectile function and avoiding incontinence. I am lucky to have private medical health care, which made this affordable (there is another blog coming on this subject, but today I am talking solely about my experience with the operation). 

I also saw the anaesthetist. She was very matter of fact in her manner and enquired about allergies, reactions to anaesthetics etc. After all of the paperwork was done, I had about an hours wait before I was walked down to the operating theatre, by a very nice young Italian nurse from Verona. We had a pleasant chat about how she was finding London. When we arrived, there was a debate about the trolley I was on and whether it was long enough. I was given a spinal block and a full anaesthetic. I said a quick hello to professor Eden as he went in. The spinal block was not overly pleasant. As it takes effect, it feels like sciatica, but the sensation doesn't last very long. Then I was given oxygen and the anaesthatist asked me where I was planning to go on holiday next. I don't recall the answer, as the general anaesthetic knocked me out.

I woke up around three hours later. I hadn't got a clue where I was. My initial thought was that I was still in Lourdes with my HCPT group (I was there last week) and I had to get up to help someone who needed care. The nurse in recovery was rather bemused when I tried to get up. I realised that this would not be possible. Around my midriff was rather sore and I was very tired. I was wheeled back to my room. I must have dozed off when a nurse woke me up. She advised me to try and have a drink. I was told that I could have light meals, as people generally felt nauseous (I didn't). A short while later, Professor Eden arrived. He informed me he'd spoken to my wife and that the procedure had been successful. He had been able to completely spare my nerve bundles. I thanked him and he went off. I just wanted to rest. I had a few glasses of water and asked for a cup of tea. As I started to feel more with it, I realised just how painful my midriff felt. The nurse was keen to get me up and in the chair. She informed me that the more quickly you move, the better you recover. For my evening meal, I had a light consomme and some bread. I wasn't that hungry. 

I had a fitful nights sleep. The cathetar is not particularly pleasant and when I moved it hurt. I was able to take paracetamol every six hours, which to some degree numbed the pain. I the morning, Professor Eden popped in again and told me I could have some tea and toast if I was hungry. He'd seen the tweet I'd posted and we discussed the issue of prostate cancer and men. I told him that I was very relieved to have now had surgery. Treatments such as neurosafe, which give men the best option for maintained sexual function, should allay many mens fears about surgery. There are men dying as they do not want to lose function. I am 60 and it bothered me. For a younger man with no children, it could be devastating to be rendered impotent. IN my opinion, the NHS and NICE need to recognise this and give younger men, without the money, the option of neurosafe. Professor Eden told me that the NHS simply doesn't have the resources or pathologists to do it. I suggested that the NHS needed a plan to change this. His opinion was that the NHS doesn't have a plan for anything and our politicians are to blame, being focused on the short term electoral cycle. Regular readers will not be surprised to learn that I wholeheartedly agreed with him.

I spent the rest of the day being cajoled to get up and walk around. I had a visit from the physio team, who took me for a little walk. It was rather painful due to the operation wounds. I was told not to lift more than 5kg, not to drive for at least 7 days and to walk around as much as possible, as this is key to getting your body working. I will have to wear the cathetar for two weeks and then I will have to do some serious pelvic floor exercises, to get my full continence back. I was also told that whilst the stitches are in place they may affect this. The view is that I should be back where I want to be within six weeks.

I spent last night in hospital. I got a better nights sleep. This morning I had a quick handshake and thank you very much with Professor Eden, then going through the discharge protocol. This involved making sure I knew how to manage the Cathetar, which I will have to change/empty myself. My dressings were changed, the view was that they looked in good shape. Some blood tests were done and then at 11am, Clare arrived to take me home.

As I mentioned, I am sitting here, having a tea, feeling a bit sore and tired. I am immensely relieved that I have had the treatment and from what Professor Eden has told me it is very likely to be successful. A journey that started with a PSA test in 2011hopefuly finishes with this procedure, although there will be follow up checks etc. Had I not had that PSA test, given that I had no symptoms at the time, I probably would never have realised there was a problem until it is too late. Prostate Cancer kills 11,000 British men a year. If the government and the NHS got their act together, than number could be nearer zero. When you think of it, that is criminal.

Here's a little song I wrote about my situation

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