On Wednesday 31st August, the day after my catheter and staples were removed, I started a walking regime to help me get as fit as quickly possible. It is now a week later and since then I have met the steps target set me by my Vivofit everyday. While I continue to hit the target the Vivofit increases the step target each day. Last Wednesday this was 7728 and by Tuesday 6th September it had increased to 9347. Over the week I walked 82,912 steps, an average of 11,845 per day, about a 5 mile average. Walking was the only form of exercise that was recommended for the first few weeks with no further instructions other than to “listen to my body”, which I did. Towards the end of the week I started to incorporate a few hills. I’ve been very happy with the way it’s gone and feel significantly better now than I did a week ago. More of the same for another couple of weeks I think although I will not be particularly worried if I don’t meet the targets set every day from now on.
I went to the squash club at Heaton on Thursday 1st September, 11 days after the operation, and had about a 10 minute knock by myself to see how it felt. I didn’t push it at all, just hitting to myself down the side walls in the channels and some figure of 8s at the front to minimise my movement and not damage myself. I felt fine with no twinges. I did the same again on Monday 5th with the same result. I will start going regularly to build on this but it will be a while before I play against an opponent, even socially. Thursday I should be able to return to doing a little coaching as before. My weight has stabilised at around 12 stone 9 or 10, about 6 lbs lighter than when I went in for the operation so my strategy to not put on weight seems to be working so far.
With a view to starting cycling again I have been researching saddles with a cut-out to relive pressure on the perineum. Normal saddles put pressure on this area and can be quite painful for quite a while after a radical prostatectomy as this bears directly on the area where the urethra has been joined up. This gets better over time apparently. I probably won’t ride until I’ve seen Mr Singh and I may need to know if I should delay until after radiotherapy if that is needed.
I have spotted on a couple of occasions a very small blood clot being passed in my urine but have decided not to worry about it. I have 4 weeks before my scheduled appointment with Mr Singh and the BRI (when I will get the histology report and learn if I need radiotherapy) and will mention it then if it continues.
On Tuesday 30th September August the catheter and staples removed. The catheter removal I had dealt with before but staple removal was new and I was quite apprehensive about it. The staples are more like the staples you hammer into wood to hold wires in place rather than the office type of staple that go through paper and bend round so the procedure was quick and painless apart from the odd brief sting. Normally staples come out between 10 and 14 days but it made sense to remove them at the same time as the catheter appointment in this case if the surgical wounds are sufficiently healed, which they were.
Then it was just a case of sitting in the waiting room and drinking slowly and steadily two 700 ml jugs of water in order to produce three sufficiently prodigious wees. This involved going to the gents’ toilet and weeing into a bottle with you name on it on a rack – there were 5 men going through this procedure. Every now and then Staff Nurse Sarah (who I thought of as Nurse Catheter) would check the bottles, record volumes and empty them. I managed this without too much difficulty and was allowed to leave at about 11.00 am when Julia picked me up to take me home. I was given a few incontinence pads to take home with me and I was advised to use one straight away before I got of the treatment table as there might be a sudden surge as I stood up. Nothing happened but it was better to be safe than sorry. It is not always as straightforward as this I discovered talking to the other men. Sometimes there is no flow and the bladder just fills up. In these cases a catheter had to be installed again. We were advised to only drink about one small gals of water per 15 minutes as in the past men keen to get away had drunk 2 jugs full straight off in their haste to get away only to find they couldn’t wee and put themselves through some serious pain before a catheter could be replaced.
On arriving home I went for a walk around the local park and felt immediately that I could walk better and in more comfort now the catheter had been removed and felt optimistic about gradually building fitness again although this would be restricted to a walking only programme for a few weeks. I wore the pads for the first two days but didn’t have any leakage problems at all so have pretty well dispensed with them although I’m not fully confident. Most men suffer to some degree or other form incontinence after the operation. For many it is only for a few days, perhaps a couple of weeks. For others it is a constant problem that requires further corrective surgery. It looks like I will be one of the few who don’t suffer at all. If this is the case I think it will be down to two factors, my general level of abdominal fitness through cycling, walking and racketball and the fact that I have been pretty assiduous in doing my pelvic floor exercises for a couple of months before the operation.
My key advice to any man who is going to have this operation is to try to lose a bit of weight and get fitter if necessary but in any case do your pelvic floor exercises. I was instructed to do the exercises as soon as the operation had been done and not wait for the catheter to be removed. While incontinence remains a problem you should do the exercises the recommended 3 times a day. Once continence is achieved this can be cut down to twice a day, for life. Given that you can do these any where at any time, standing up, sitting or lying down, and they only take about 2 minutes there is no excuse. I shall continue with 3 times a day. I may yet have to have radiotherapy, depending on the histology reports on my prostate and the surrounding tissue removed. This can also produce continence problems as side effect so I want to be in as good nick as possible just in case. I will find out if I will be getting radiotherapy when I see the consultant again on the 6th of October.
Yesterday, Wednesday, I went on a fairly hilly walk of about 2.5 miles and am feeling stronger every day. I will be building up the walking over the next 3 weeks before I have a short easy bike ride, probably only 10 minutes or so somewhere flat, to see how that goes. I’ve had to withdraw from two racketball tournaments in both of which I was lying 2nd in my group. However, the 2016 Yorkshire Racketball Championships are to be held on November 26th and 27th and I hope I may be able to play in this, in the over 60 group.