Better sex

Today I finally had to acknowledge a change that may be the first side effect of my prostate cancer and treatment.  At first I didn't notice any big change but, over time, it's continued to increase to the point I can no longer ignore it.

While surfing the net this morning I became aware of a change in the advertising along the side of the screen. The internet search engines have, apparently, identified me as someone inordinately interested in prostate cancer. Here is the list of ads that appeared at the same time:

Shocking Prostate News

Prostate Cancer Treatments

Advanced Prostate Cancer?

Prostate Pill Review

Shrink Prostate Fast

Bladder Cancer Causes

Not sure how that last one sneaked in there but it is, admittedly, anatomically close.

I fear I've become a one trick pony to the all seeing eye of the internet. Gone forever are all those provocative ads seeking single men for lonely Russian women, or women in my area over 50, or the never ending search for someone who can satisfy Katrina's burning desire.

Gone too are those ads promising to add inches (no, not to my height), increase my stamina, and make me irresistible to women named Katrina.  Nope, I get prostates...but then again, I am currently short one prostate.

OK, technically all this has very little to do with sex, but I have found that the better my title, the better traffic my blog generates. Deal with it.

I've got issues

There are some issues that bubble to the surface when recovering from treatment that should be addressed (feel free to either provide insight or add issues of your own to those below):

1. What the heck does one do with leftover diapers? Mine are unused (I'm sure you're happy to know that.), and will not, hopefully, be needed in the immediate future. I did reserve one to utilize as a pistol range target...sort of a “Take that incontinence,” statement.
2. Approaching three months following surgery, how can I continue to use my “condition” to get out of doing things like shoveling snow, vacuuming, washing the car, and attending events I'd rather ditch?
3. What do I say to people who ask if I'm OK? I've never had cancer before, how the hell should I know?
4. When people ask me if “everything” is working...how much to they really want to know; and how much is any of their business?
5. Is it inappropriate to discuss my catheter experience while out drinking wine with friends?
6. Does anyone really want to see the incisions?
7. Will husbands get pissed if I continue to tell wives they should nag their spouse about prostate health? Do I care?
   I'm sure there are more but you know, ever since the surgery, I've noticed I...oops, almost started again.

More questions

I asked for additional questions readers believe important to be asked when prostate cancer has been diagnosed; here are a few submitted by one reader:

What other ways to treat this are there?
 
  Why is this the best for me?

Where can I get other treatment methods explained and/or done?
 
What happens if I don't do anything for a while?
 
  How long can I wait? 

Is there a support group that can help me and my loved ones, before, during and 
after treatment? 

What am I facing, nerve-sparing or non-nerve-sparing and why?
 
If the ED is severe, how can it be dealt with? Medications? Surgical 
implant?
 
If incontinence is a given, how can it be treated? Sling? Urethral
sphincter? 

                  How certain are the results?

We have not exhausted the questions that might be asked (In fact, my first question was, "I've got what?")...feel free to continue to offer questions you either asked or wish you had asked (I always think of the best questions about thirty minutes after I need them).

Husband won't do what she'd like

Over the weekend I ran into a friend who told me she reads this blog but can't get her husband to do so. Her husband has been treated for prostate cancer, but his PSA is climbing again and she's concerned (so is he, I'm sure).

Having limited experience, and absolutely no qualifications, I'm not the best person to deal with her husband's situation from a medical (or almost any other) perspective, so I don't blame him for not finding your truly as a source of information. I can, however, understand how upsetting it must be to have made your treatment decision and then be faced with having to do it all over again...and things get a little more difficult the second time around (which, by the way, is not true only of prostate cancer).

Perhaps if another reader who has had a similar experience would choose to share his story it would be of benefit (and that's really my agenda, to become a location for the exchange of information, education, and connection...'cause I certainly don't have enough juice to carry this alone).

On a personal note, this morning I ran the same distance I ran just a few days before my surgery. It felt good at the time, but now I'm having some discomfort in the area of the incisions...perhaps a bit too much too soon (yet further proof...as if needed....I'm an idiot).

Questions please

As I've preached recently, no one is going to make any decisions for you, so you need to gather as much information as possible. To that end, there are questions any prostate patient should ask...besides “What the hell is your finger doing there?”  The question list below is far from exhaustive (and more is better), but it's a start.

What are my numbers?

In order to speak intelligently about your condition, you need to be able to give doctors the results of any testing you have had including, but certainly not limited to, PSA numbers (I know, I know) and, if you've had a biopsy and the results were positive for cancer, your Gleason score(s).

This may sound obvious, but while my urologist referred to my numbers he did not give them to me until I asked.

Where can I go for a second opinion?

Your physician should be eager to provide this information...if he/she isn't, find another physician.

How many cases like mine do you treat? What are your outcomes?

Having decided upon surgery, I wanted a surgeon who performed a boatload of procedures like mine...no practicing on this body. I opted for a surgeon who performs 400 robotic prostatectomies a year.

What are the likely post-treatment complications and how do I address them?

I was well aware of the possibility of erectile dysfunction and incontinence following my surgery, and had a plan in place to deal with each.

It's always a good idea (actually, it's essential) to have someone go with you to any consultations. There often is so much information provided you might miss something; another person might also ask important questions that haven't occurred to you. Further, it's good to have someone there to provide support as you are confronted with the realities of your condition or disease.

Finally, here's the first “There Goes My Prostate” challenge...send me questions you think are important to ask and I'll post them here for others. Now, send me your questions!

It's your gland...

I received another note regarding the PSA test, questioning whether one should refuse the test based upon recent articles indicating the test does not, in fact, save lives.

The extent of my knowledge and qualifications to discuss matters medical is restricted to my own experience...in other words, I have no valid credentials to make suggestions or offer opinions on such matters.

Warning: Pay no attention to the man behind this blog (medically).

That being said, I mentioned in an earlier post a friend who brought her husband to me at a social event and insisted he tell me his PSA test results. After we both shared a moment of discomfort (obviously we're both smart enough to be scared of our wives), he told me his test came back a 56. 56? Holy crap, mine was only 5.2 and I was having my prostate removed! I suggested he seriously consider the biopsy his urologist ordered.

Well, he had the biopsy and guess what? No cancer, zero, zip, nada, none. He was placed on a course of antibiotics to see if that might offer a cure. Two months later, his wife told me he had another test...the number was now 84. The doctor prescribed another course of antibiotics and the couple is seeking a second opinion to determine what the hell was going on.

I mention all of that for one reason, a PSA test, as I have mentioned, may not be definitive, but it can be a marker for some extant process. If a man's PSA number is out of the normal range, or is moving up at an accelerated pace, it's a pretty good hint additional testing may be indicated. It does not mean cancer...many things can cause an elevated score (even intercourse within a few days of the test, according to the Johns Hopkins Health Alert); but wouldn't you like to know what's going on? I would.

The decision of treatment is always the patient's. Did I rush to surgery before it was absolutely necessary? Probably, but that was my decision and I'm glad I made it...I'm just as happy for those who choose other treatments including “watchful waiting.” I cannot be so happy for those who choose to ignore the issue. But, hey, it's your gland.

I got nothin'

The muse has left the building. My plan...drink enough wine tonight to reignite cognition.