At least they're not condoms

There are aspects of prostate treatment that I haven't talked about...until now.

As one approaches most of the treatment options, one begins to plan for the post treatment effects mentioned by physicians and in the literature. For most these include incontinence and impotence. The hope is that these will be temporary lasting from a few days to a few months...or more than a year, but temporary.

While impotence is nothing to look forward to, it is not something that should cause spontaneous embarrassment at awkward public moments...unless your life is a whole lot more exciting than mine. Incontinence, however, needs to be planned for to avoid public exposure..."Ummm, Bill...why is there a puddle growing beneath your right foot?"

In anticipation, I decided I should stock up on necessary supplies before the surgery. I was advised to not go for the generic or store brands, but to go top shelf...Depends.

But going to the store I found myself walking quickly by the display, not even looking for any length of time for fear someone would think I was shopping for me.

"Holy crap, this is just like trying to buy condoms when I was a whole lot younger." I thought, "And that's just stupid. I'm an adult, shopping for a medically necessary product for a procedure I'm going to have soon. I have every right to buy Depends and not be embarrassed, I have every right to purchase what I need without public humiliation. Depends are on the shelf for people to buy. It's time to grow up."

So I got back in the car, drove home and asked Lucia if she'd buy my diapers. She did.

As I mentioned in an earlier post, ultimately I experienced zero incontinence...but I wore the Depends (now available in sporty gray as well as white) for several weeks until I was confident I was in fact in control. Then I decided I should at least wear a pad for a while...just to be sure. So I went online and found that Depends also make a pad for men, "Guard."

This time, however, I steeled myself and went boldly to the store, walked directly to the display, located the Guards, took a package from the shelf and took them to the cashier...all by myself (I'm a big boy now!).

OK, I did sort of hide them as I walked through the store, but I did it! And I even resisted my inclination to say something stupid to the cashier like, "If my father doesn't like these, may I return them?" Nope, kept my mouth shut (no small task for me).

This is one of the aspects of treatment I had not anticipated, but I find there are many things I am learning about myself as a result of the surgery...and that's a good thing.

Now I think I'll go buy some condoms.

I'm not qualified

This will be very brief because, as noted above, I'm not qualified to discuss this in any depth.

When one is diagnosed with prostate cancer the education process goes into hyperdrive as one explores the disease, the disease process, treatment options and more. One statistic I found interesting from one author was 90% of prostate cancer can be attributed to diet.

While I have found arguments on both sides of the issue, there seems to be enough support for the dietary connection (correlation?) to warrant further study. From a personal perspective, my diet BL (before Lucia) was generally inadequate and loaded with everything I now read provided a heavily greased runway for cancer, heart attack, stroke, high blood pressure, lupus, dandruff, bad feet, enlarged ear lobes, and hair loss (not really...just threw that last one in).

In talking with doctors during my prostate cancer journey, no one would claim a definitive dietary connection, but most suggested our consumption of wheat, dairy products, and sugar seem to be contributory.

A bit too late, we have eliminated most wheat from our diet (there really are some excellent alternatives), never used much dairy, and we avoid as much sugar as possible.

I'm reading more about vitamin/supplement support now, but it's going to be a long time before I will feel comfortable commenting on that subject. But I certainly welcome opinion and information from others.

In fact, as I continue my education I welcome comments to assist my understanding of all matters nutritional.

I have not had a baby!

Five weeks and two days after surgery I'm spending my second full day at work and feeling pretty good. However, I was reminded last evening that I've still got recovering to do.

During a conversation with Lucia over Manhattans and hors d'oeuvres, I happened to say something I found incredibly funny (I often think I'm one of the funnest people I know)...anyway, I began to laugh heartily and, for the first time, suddenly leaked! Not much, just a few drops, but enough for me to notice. I was stunned; I had expected to experience some exercise induced leaking when I resume running in a few weeks...but not laughing!

I have been doing so well in every area of recovery. Thought I had all the bases covered until, as Roy Clark sang (sort of) "A little bitty drop let me down." Guess I'm gonna break out the pads for New Years Eve as I expect to be hysterically funny that night.

Lucia's response, intended to make me feel better, was to assure me that every woman who has had a baby occasionally leaks when laughing or sneezing (Oh shit, you mean this could happen when I sneeze?). Obviously it was not exactly what I wanted to hear.

Because I had, up until this moment, been waayyyyy ahead of schedule I had stopped the Kegels (restarted those immediately), stopped the Viagra (hand me that little blue pill), and decided I have had enough rest.

I needed to be reminded of the impact of prostate surgery, and the importance of not taking shortcuts to recovery. A trauma has been experienced, and I need to respect the healing process...all of it.

What the heck, maybe I'll just be mildly amusing New Years Eve...naw, I really get a kick out of me. Besides, I have not had a baby, dammit.

Yoda Knows Best

Yesterday I ran into a friend whose husband recently died of prostate cancer. Once again she expressed happiness at my progress...progress her husband did not have the opportunity to enjoy. Actually, that's not accurate, he had the opportunity, but chose to ignore the problem until it progressed beyond the point of treatment. His choice was not "watchful waiting"...it was simply waiting.

If these ramblings have any theme it is this...prostate cancer, detected early, affords one a wide variety of treatment options, all of which boast records of very positive outcomes.

Yoda said it in Star Wars Episode V, "Try not. Do or do not. There is no try." Trying implies less than full dedication to the outcome...this is life we're talking about here, it deserves one's best effort.

While it is still way too early for me to report on the ultimate outcome of my treatment, I can't imagine being diagnosed two and one-half months ago and still not having made a treatment decision. With so many options available, one might argue the wisdom of my choice...but acting upon a choice (even if it's the choice of watchful waiting) is the first step toward a cure.

I don't want to meet any other friends deprived of Christmas with a loved one because of something as responsive to treatment as prostate cancer. Bend over, smile, and know you're doing it for those who love you...then, if something is detected, "Do."

A quick observation

Prostate cancer, like any other serious illness, tends to focus one's attention upon that which is truly important in life. This year the blessings of good friends and loved ones easily eclipsed the more commercial aspects of the holiday. While I have intellectually understood this for a long time...this year my understanding is visceral.

May you all find peace, love, and friendship.

We have liftoff!

This story really began Tuesday evening when I decided to forgo the prescribed Viagra regimen. Imagine my delight on Wednesday, four weeks after my November 21st surgery, and Thursday when Milestone #6 moved into the accomplished column! That was an unexpected early Christmas present.

I've decided to wait until next week to resume the therapy and see if there is any change in this uplifting development...a firm decision.

The miracle here is the precision possible with the da Vinci robot in the control of an experienced surgeon. The name "nerve sparing surgery" is not just marketing.

When I chose to go the surgery route, I did not anticipate such a positive outcome with respect to incontinence and sexual function. While recognizing not everyone can expect the same result, I have become an active advocate of the treatment choice if it is appropriate given the cancer/patient profile.

Having an old friend back in my pants...oh wait, that sounds wrong. Resuming an important part of life does much psychologically for continued recovery. Today, I have only one area of concern...that being one of the incisions which does not seem to be healing like the others (looks a bit angry)...but I'll give it some time.

I identified six milestones in the evolution of my prostate cancer, and I was prepared for the journey to last from several weeks to several months or longer (perhaps much longer). Having past all six before fully recovering from the surgery (still tire easily), I feel truly blessed in this season of miracles. Gotta establish additional milestones!

Now, let's see what else I'm up for................

Patience is a Virtue

After four and one half weeks of recovery and hearing, “Just be patient, it's going to take time for you to get back your endurance, your energy, etc.,” I'm sick of this. Although I feel my recovery is not only on schedule but even ahead of schedule (stay tuned for a big announcement tomorrow), I have to admit I'm growing more and more impatient with each passing day.

Patience is a virtue...get me a bucket! I'm doing everything I have been told to do but the incisions still hurt, I still tire easily even though I take several naps daily, and if I sit for long periods of time I feel pains in places I didn't even know I had before the surgery.

I have never had an extended illness, nor have I had surgery, and I've always been a quick healer. Intellectually I understand the trauma my body has experienced, but emotionally I just want this all behind me.

Yesterday I tried to put in a full day at the office...made it from 7:00am until about 3:00pm before I had to give up and head home to the couch upon which I've been living for the past month. Today is slightly less ambitious with plans to be here from 8:00am until about 2:00pm...but there is so little to do at home.

Thanks to the internet, I can stay in touch with business partners and activities from my couch...but it's just not the same. I play well with others; alone, I'm a mess.

Patience is a virtue because it's so damn difficult, and that's one of the greatest challenges as we recover from our chosen treatment. We have to give our bodies the opportunity to renew. Be good to yourselves and (buckets up) “be patient.”

Christmas Tie

I only have one nice Christmas tie...I also have one stupid Christmas tie (the kind with the funny Santa and his reindeer). Anyway, I didn't think I was going to have an opportunity to wear either this season...until today(and neither one will do me any good next week).

This morning I decided I'd try working an entire day for the first time since the surgery...unless I get too tired. A 7:30am board meeting presented an opportunity to wear real business clothes for the first time in a month. So out came the dress shirt (haven't tucked-in a shirt for a month), the classy Christmas tie, nice slacks with a belt (which I also haven't worn in a month), and jacket.

Lucia often says, "When you feel your worst, look your best!" Well, I don't feel my worst, but dressing certainly has done a lot for my attitude and I believe I even have more energy. Once again, Lucia knows best!

I have much for which to be thankful this Christmas season...indeed, I have received more than my share of blessings during my journey with, and without, my prostate. May your holiday, whatever your tradition, be filled with love, laughter, and health.

I continue to receive messages from readers. This morning I received a note from a twenty-five year old asking questions regarding prostate health not just for himself, but for his brother and father as well. Perhaps the message is starting to be heard.

New insight...well, expanded insight

Yesterday I had an inspired thought (a rarity for me). Why not promote my blog on sites with a primarily male audience since I'm trying to expand discussion among men? Logical...duh!

So I posted on the three primary gun owner sites I frequent. I received a great number of responses and traffic on the blog skyrocketed. I heard from a number of men who had been diagnosed who reported on their treatment decisions and post treatment experience.

But the insight came from those responses that detailed colonoscopy results finding polyps, but no prostate problems...others private messaged me to ask me what a prostate does and how it is checked.

We have a lot of educating to do. These were not dumb men, simply men who had never received any information regarding prostate health...which is sad in light of the position prostate disease ranks among men.

Please talk about the issue with your friends, sons, sons-in-law...OK, not around the Christmas dinner table, but when the opportunity presents itself. There are a number of good websites on the topic I'll publish at a later date; and if you know of good websites, please let me know so I may add them to the list.

Yet another killer we can stop with education and early detection.

Happy 4th...

Today marks the fourth week since my surgery, and I mark the anniversary with a realization that I've come a long way from November 21. Endurance continues to improve daily, and I'm beginning to feel like myself once again.

In an unrelated phone call this morning, a young lady told me she enjoyed reading this weird blog. Hmmmmm, I originally began this to assist men facing prostate disease, and to increase awareness of the need for men to discuss prostate health openly, honestly, and frequently. It never occurred to me women would find the subject of interest...this, of course was short sighted on my part.

Prostate cancer and other prostate health issues affect more than just the man who's body happens to houses the offending tissue. As Ken Jones so often reminds us, prostate cancer affects the wife as much as the husband...Lucia enthusiastically agrees.

Then there's the matter of women just being better about monitoring their health than are men. Perhaps it's our macho coming out, but I think it's more likely denial and fear that keeps men from seeking medical attention when we know something just isn't quite right. "It'll be better in a few days,I don't want to bother the doctor." is often our fallback position. We're also cheap.

Ladies, keep us honest and force us to talk about our health. You express your concern for prostates and we'll express an interest in boobs...oh yeah, we already do that but it has very little to do with matters of importance. Maybe we'll grow up some day.............................naw.

I can see light at the end of my recovery...it's still a way off, but I can see it. I'm glad I didn't ignore the problem, or postpone treatment; and Lucia was integral in keeping me focused on dealing with it. Once again I discover we have a lot to learn from the women in our lives just as they keep telling us (over, and over, and over again).

PS Keep those verses coming for the song in the previous post...you know you want to!

To the tune: "Walking in a Winter Wonderland

Prostate's gone, I was freakin'
'bout how long, I'd be leakin'
Today look at me...incontinence free
Walkin' 'round in Big Boy Underwear

Now, all y'all (the proper plural of the singular y'all) submit your own verses.

Milestone #5 BBUD

At the risk of speaking too soon...tomorrow I plan to celebrate the fifth of the six milestones I identified earlier...that being BBUD "Big Boy Underpants Day."

From the day my catheter was removed, November 30, 2011, "a day that will live in infamy," I have been wearing Depends in anticipation of the post prostatectomy incontinence referred to in all the literature and during doctor's visits, incontinence expected to last from a few weeks to more than a year.

As I mentioned in another context, my experience is peculiar to me and cannot be generalized to any other patients. Yesterday the doctor asked me about incontinence and I was able to tell him that, to date, I have not had any leakage...not a drop! I expect there may be an issue when I resume running in a few weeks, but in normal daily activities (or as close to normal as the recovery period can be) I have had zero, zip, nada.

With no medical knowledge upon which to base my opinion, I attribute this remarkable record to three things...the skill of an experienced surgeon, the unparalleled precision of robotic surgery, and the fact I started the Kegel exercises several weeks before the surgery rather than waiting until after the procedure as mentioned in the literature provided.

This is yet another concern that haunted me prior to the procedure that has proven to be baseless. Again I urge men not to avoid treatment due to anticipated pain, discomfort, or problems...you can deal with whatever comes your way, but don't reach forward to borrow trouble.

And so tomorrow...it's Big Boy Underpants Day for me; leaving one milestone to go (see earlier posts).

Here's the point...

I received an email today from a friend who wrote:

"I keep pushing my Buddy, XXXXXX, to do something(Laser, Seeds or
Surgery) with his; but he is avoiding the Issue!!!"

I responded with a story of someone I know who took the same approach and ultimately lost what became a battle for his life. Of course, I also reported the gentleman I spoke with who has been monitoring his prostate cancer for eight or nine years and is doing just fine.

But with so many treatment options and such positive outcomes for each...why the hesitance?

Perhaps it is avoidance as my friend suggests. Doing nothing does take less time (duh), and there are no side effects (unless you consider potential death a side effect).

I did not have to choose surgery, and I did not have to have surgery so soon after being diagnosed. On the other hand, I am recovering quickly with improvements every day, and I can easily see the time in the not too distant future when the minor inconveniences I have endured will be only memories.

Surgery and radiation are indeed barbaric solutions to prostate cancer, but they are effective, survivable, and available now. Complications can, in all most all cases, be mitigated.

I understand anyone's hesitance and concern (or fear), but I would do it again in a heartbeat if I had it to do over again. I'm free of prostate cancer and I will be running again in a few weeks...what's not to like about that?

For God's sake...more importantly, for your family's sake and your own...do something, and do it today.

Can we talk...

I've mentioned it before, men don't talk enough about this stuff. It was amazing how many men came forward to talk to me after the diagnosis was made and I started seeking information.

My neighbor, from whom I have lived across the street for eight years, told me he had his prostate removed about ten years ago (when he was just 46). Another man approached me at a social and literally yelled, "Hey, I hear you have prostate cancer!" I affirmed his statement and he responded, "I had my first radiation treatment today." I congratulated him on taking action.

At the same social, a friend dragged her husband up to me and said, "Tell him...go ahead, tell him." The poor guy told me he had just received results of a PSA measuring 56. "Tell him he has to do something, Bill." she said to me. I spoke for a few minutes about my biopsy with the uncomfortable husband, then said we could speak at another time (this story has a happy ending in that his resulting biopsy found no cancer...now the question is, why the elevated PSA?).

Fellow Rotarians came forward to tell me of their positive results from seed implantation, others told me of how happy they were with open radiation...still more who had opted for surgery.

The point is, there is a wealth of experience and information out there that can be tapped if we are aware of it. That's what this whole stupid blog is about, just starting a discussion.

Just before my surgery, a friend suggested I contact a friend of his who has been living with prostate cancer for eight or nine years. I contacted the friend and was blown away. He had been diagnosed years ago with a profile much like mine. Unlike me, he had adopted a very aggressive campaign to find the best treatment...traveling all over the country, and beyond, to interview the creators of various treatment options and visit the top treatment centers. To date he has not found a treatment that provides him the level of confidence he demands. He regularly monitors his PSA and has regular (almost disturbingly regular) biopsies and, to date, the disease progression is slow and causing no problems.

"I know I might wake up some morning with a pain in my side and be told the cancer has spread beyond my prostate and is now a real problem," he says, "but I'm just not convinced they have a treatment that will guarantee I won't have complications."

OK, not my choice, but one that deserves to be heard and considered. If you have been diagnosed, treated, or waiting for treatment...talk about it with anyone who will listen, it will help you both. End of sermon.

Life after cath....

The most frustrating thing about recovery seems to be the time it takes. My lack of endurance amazes me as I have to stop so frequently to rest...but, rest from what?

The days are filled with time on the couch intersperced with naps and brief periods at the table eating while thinking how much I'd like to be back on the couch.

In addition to the surgical incisions, one can feel things happening within, and bleeding continues to remind me of the intrusion suffered.

Little to no pain to speak of...and I have experienced none of the expected incontinence (hard to be pissed off about that!). The nightly Viagra treatment produces the expected results indicating, to this medical novice, encouraging signs the nerve sparing surgery has been successful.

Increased walking each day and short trips to the store point to slow but continued progress...so, I'll rest, then rest more, and be satisfied with life at a much slower pace. But I have to be honest, I can't wait until Jan. 15 when I'll be OK'd to return to running (that ought to be a sight...my leg muscles have already atrophied to a great degree).

CFD...Catheter Freedom Day

Wednesday, November 30, 2011, will always be remembered as CFD for me, a day I had looked forward to since before the surgery.

Getting dressed, I looked forward to seeing the doctor once again and receiving recovery care instructions.

The drive was uneventful and could not have been at a better time to avoid all rush hour traffic. Arriving at Riverside, we found a parking place and I had to control my urge to run toward the doctor's office complex.

Note: for this special occasion I chose a simple black bag to conceal the cath
bag...I know, I know...black is for evening wear, so sue me.

Arriving at the office I was told the doctor's nurse would be taking care of me; oh joy, yet another woman I've never met getting physical with my wiener (which sounds like a good thing...it isn't). Oh well, by now I have lost all humility.

Kim comes into the treatment room and tells me to take off my pants and underwear and cover up with the sheet...then, she's gone. I do as instructed and sit on the table waiting eagerly to lose the tube.

When she returns, the first thing Kim does is remove the staples (which had concerned me but proved to be without discomfort) and cover the incisions with small pieces of tape she tells me will fall off in 7 to 10 days. Then, she says, "Lay back." Here it comes.

Here's the deal, the catheter is held in place by a balloon in the bladder. To begin the removal, Kim took a large syringe and deflated the balloon...at one point there was a sound (I think) and a definite sensation of something happening inside. Kim said, "Did you feel that?" Ummmm...yes. "That's the balloon. Now I'm going to fill your bladder with water." and she began to inject syringe after syringe of water into the catheter. Then she began to pull.

Holy Crap! I thought the catheter was around seven inches in length...WRONG! She pulled...and pulled...and pulled. My guess is about twenty inches, felt like forty. No pain in the process, not even the slight burning sensation Kim had suggested I might experience. I have no idea where all that tubing was, but I'm surprised it didn't interfere with my swallowing!

Next I was handed a beaker to collect the water that had been injected...which appeared to be mixed with an equal amount of blood. I was a bit concerned by the amount of blood, but Kim told me that was absolutely typical. Then she told me to get dressed while she got my parting gifts.

For anyone reading this in anticipation of surgery let me emphasize I experienced no discomfort throughout this process...my experience may not be typical, but my guess is most will be similar; there is nothing to fear.

When Kim returned, she had lengthy written instructions (time to begin those Kegel exercises) as well as prescriptions including one for 90 Viagra tablets (half a tab daily for six months) and one for a vacuum system; both to assist in the recovery of sexual function.

Then, thirty minutes after we arrived, we were walking out the door toward the car "catheter free!"

Now the recovery begins in earnest.

First week home

The first week at home was uneventful with the exception of learning to navigate through the activities of daily living with a four foot hose exiting my body and terminating in a bag. Peg the Wonder Nurse suggested I keep the bag inside a pillowcase to help avoid the possibility of infection from household dust/dirt (it also makes for a handy way to carry/conceal the bag).

Cleaning the catheter and entry point a few times each day are important to further avoid infection...something with which I never did become comfortable. But the fear of infection is a powerful incentive to do as instructed (I had this irrational fear that I might accidentally pull the catheter out...not a possibility, but that's the definition of irrational).

The solution I found to showering was to leave the bag outside the shower curtain on a small stool...then try not to pull it off during the shower. Lucia remained within an arms length whenever I showered as my balance was suspect.

Sleeping arrangements had to be found that would allow me to remain on my back (which I hate) to accommodate my incisions while allowing the bag to rest on the floor. We put a couch in the living room where I would spend the vast majority of time those first seven days.

Having never had surgery, I was amazed at how easily I tired and how much time I spent sleeping...it seemed like I napped every two or three hours.

My appetite was good and, thanks to not requiring any pain medication, I found wine to be a great treat with meals (could get used to that...oh, who the hell am I kidding, I've been drinking with my meals for years).

I did try to get outside to walk every day...not too far, and it was great to be out seeing neighbors and feeling compelled to explain the pillowcase I was carrying (I did not like the leg bag that was given to me at the hospital, too small and, thus, requiring maintenance too often).

No adventures to speak of during that first week at home, just waiting patiently for the day the catheter would be removed and I could return to life untethered.

ARGHHHHH...Insurance, Viagra, and me

To be fair, I haven't even begun to receive the big bills for my surgery and hospitalization...but the insurance company is already driving me nuts.

On the day I had my catheter removed (remember...CFD?) I was given two prescriptions, one of which was for 90 Viagra tablets to be split in half and taken daily for six months. Nerve sparing robotic surgery is intended to allow one to return to normal sexual activity and Viagra promotes vasodilation following prostatectomy to preserve function.

When I first filled the prescription, I received three tablets and a $60+ charge. I was a bit confused as I had fully met my deductible and all prescriptions were to be covered. Well, I got that fixed...the next refill was another three tablets, but at no charge to me. Returning for the second refill I was told the insurance company would not cover another refill until January 6, 2012 (surprise...new deductible year, so no pay then). I am allowed just three tablets per month once my annual deductible is met.

Calling the insurance company I plead my case...this is not "recreational" Viagra, this is medically necessary therapy following surgery to prevent complications (potentially very expensive complications for the insurance company); but my argument fell upon deaf ears. I'm filing an appeal, but expect no luck.

So here's my deal...I want to begin a Viagra Bank for prostatectomy patients. Here's the way it works: Every time we go to the doctor, we request a sample of Viagra...we then send those samples to someone in need of the therapy if they promise to do the same after their need is met.

Look, this is going to cost me about $1,800...ouch! If someone can get samples but doesn't need them, I'll take every tablet I can get and gladly do the same for the next patient. If insurance isn't going to accept the therapy as medically necessary, we can do this ourselves. Whadda ya think?

This is cool...

OK, the story just got me home from surgery on Thanksgiving day, and then I remembered what I forgot.

The surgery I opted for is a radical prostatectomy via da Vinci surgery, a robotic assisted procedure. What I forgot was to ask the surgeon if he had a video of either my or a generic procedure. Well, this morning I remembered I had yet to follow through on my interest, so I went online and guess what I found?

If you have an interest in things technical and surgical, below is a link you can follow to see a portion of the surgery. I have five "ports" in my abdomen through which arms of the da Vinci robot did it's work...you'll see three instruments in this video, and you're looking at the action through the same instrument the surgeon uses to direct the other "arms." Enjoy!

http://youtu.be/nPVP3NkaP44

Wed-Thursday...Home on Thanksgiving

After I concluded I could not go home, Tuesday evening through Wednesday evening was the most difficult time I can remember in my life. Wave after wave of nausea...not your typical, "Gee, I feel sick," nausea...but the kind where every breath was so painful I actually understood not caring what happened to me as long as the hurting stopped.

Poor Lucia tried everything to ease my discomfort only to have me repeatedly snap at her. I knew I was being unfair, but couldn't stop. I can never make that up to her, and I'll never forget her loving patience.

After vomiting several times, the nurses called in a gastrointerologist (never tried to spell that before, how'd I do?) to see me. He ordered x-rays to eliminate the possibility of physical blockage, then told me he would be back after supper with a team.

When he returned with his gut buddies, the head of the team thumped on my belly and said, "You hear that? Sounds like a drum doesn't it? That's gas in your gut, very typical in abdominal surgeries. That's what is causing the pain. If you can expel it on your own, that would be best...otherwise, we'll put a tube down your nose tomorrow and decompress it that way; you won't like it."

OK, let me get this right...I'm being told to fart and belch...ALRIGHT! I told the doctor I would not be needing the tube...and went to work.

I blasted away for an hour or so, then took a nap. When I awakened, the nausea was gone and never came back. I knew all my pre-teen fascination with farting (OK, never outgrew that one) would come in handy some day. It is an art, and now a medical technique, as opposed to the immature behavior mothers and wives claim.

I learned I probably caused the problem by accepting all the pain medication offered. The meds slowed the awakening of my bowel and exacerbated the gas problem. I never really experienced any difficult pain from the surgery itself and could have, perhaps, done with far less intervention.

Note to future patients: Take what you need, not more, and not what you want.

After the first annual "Sharp fart-fest," I continued to improve and was ready to go home Thursday after lunch...and before the tube team could return to my room.

Then it was getting dressed and walking down to the lobby, cath bag in hand, to head home. Home for Thanksgiving...I have much for which to be thankful; Lucia and I talk about that on the way home.

If I haven't mentioned it, the surgeon was a regular visitor to the room monitoring my progress. At least a few times each day, including Thanksgiving morning, he was there. I know I picked the right team for me.

Now recovery begins.

The second 24 hours

Most of Tuesday was eerily like Monday...without the surgery part. Felt good, little pain, and walking ever increasing distances. In the afternoon I was told I could go home after supper if I chose to do so.

I was so excited to go home...the staff was still too busy to spend much time with us, but I figured it would just be Lucia and me at home anyway, so as long as we could cope everything was as it should be.

After supper they delivered a goodie bag of a second catheter bag, leg catheter, and other home supplies (including a video we were required to watch on the care and feeding of the leg catheter...thrilling, but the lead character was weak).

The IV was removed...and blood went everywhere, but we soon got that under control.

I got dressed (we had to learn how to put pants on over the catheter) and the wheelchair arrived. Then, as I started toward the wheelchair, I was hit by a wave of nausea and had to stop the whole process.

"I can't go," I said, "I have to get back to bed NOW."

After a few moments of confusion and disbelief, everyone was on the same page and instead of getting in the car, they were restarting my IV. I have never felt so ill. CRAP, I wanted to go home.

In retrospect, I'm glad I got ill while still in the hospital. How much worse would it have been if it had hit me in the car on the interstate? And so, I began the next chapter of my post surgical adventure.

The catheter...a bag of fun

One is not intimately acquainted with one's penis until one has been catheterized. And that's just the beginning as, suddenly, a whole host of people (strangers and family) are exposed to that which makes us men and that which has, until now, been a relatively private possession.

Humility has no place in the hospital room. New aides and nurses rotate into your life with amazing speed and each wants to see the action. Then, they want to assist the person who will be assisting you at home in the care and feeding of what is quickly becoming a shrinking asset.

My job...sit and watch as the parade continues, knowing it's all to avoid future problems and infection. Then, everything changes.

A new nurse enters my room on Thursday (Thanksgiving and, hopefully, the day I get to go home) and I know what's coming...so I prepare to bare (bear?). OH MY GOD! LOOK AT THIS!! I throw back the sheet and raise my gown before the newcomer and ask, "Is this normal?" as I stare down at something the color of an eggplant with an appearance not unlike a partially deflated Goodyear blimp. Truly disturbing, I cannot avert my eyes...and my pulse has gone through the roof.

New nurse casually looks and merely smiles, "Yes," she begins, "I've seen all kinds of things. They get swollen, bruised, scrotums become bruised, sometimes the entire area of the groan becomes purple up to the navel." Then she yawns, pulls my gown down, and heads for her computer.

Soon, she and Lucia are cleaning the Frankenpenis (FP) as if nothing was wrong...but this is all wrong...very wrong.

Within several days, FP begins to calm down and is back to as normal as possible for something with a garden hose coming out of my body.

One actually becomes accustomed to the catheter, the required maintenance, and the need to drag the bag everywhere 24/7. And then, after eight or nine days, you find yourself on the way to lose the tube for good.

Now, back to the narrative.

The first 24 hours

The first 24 hours after surgery remain a bit of a sleepy blur...lots of sleep and images of activity around me. When awake, I actually felt surprisingly well. There was not the pain I had anticipated, nor were there any dreaded (put down your sandwich) bladder spasms I had been warned of as a result of the catheter.

The overriding lesson from the first 24 is: For God's sake bring someone with you if you choose surgery! You need someone to advocate on your behalf to an apparently overworked crew of nurses and aids...someone who hears what the nurses say to you and then insists they follow through...someone to ask the questions you're too groggy to ask...someone willing to learn the personal care routine and help you stay clean (something the staff seems uninterested in)...someone who cares for you rather than the computer charting...someone who watches everything happening. This is an important lesson...listen and learn.

We did take our first walk in the early evening after supper, I wasn't going to win any awards for speed, but I did not find walking to be painful (although getting out of bed was another story). I was surprised at how quickly I tired. Returning to the room, one of the younger nurses showed me how to get back into bed without pain; a good skill to learn early in the hospital experience.

Next up...catheters, a whole bag of fun!