PHARKOUGH!

Physio…

Firstly to the physiotherapist Di Semmler (North Adelaide | SA | AU).

Di is a continence physio.  One of several on a list given to me by the urologists.  She is closest to me for work & home.

Di spent 1.5 hours with me.  I thought this would be all about pelvic floor exercises but that is just a part of it.  She extracted everything about my lifestyle.  Working, drinking, eating, exercise, recreation & toilet habits.

By the end of it all I was very clear about what I can & can’t do post operation…the "can’t do" is the bigger list.  For the first 2 weeks do bugger all besides rest up and walking…a little at a time.  It will be another 10 weeks before I will be back to my usual activities.  Stay off the motorbike & keep out of the 4WD!

Looking after the old prostate area and the rejoined urethra is a much bigger issue than women have to deal with post any hysterectomy or caesarean!

Pre-op assessment…

This started in the theatre block of the Royal Adelaide Hospital (RAH, Adelaide | SA |AU).

It was like a factory.  About 40 of us seeing nurses, anaesthetists, ward doctors & having blood pressure & blood tests & an ECG.  Took about 3 hours.

By the end of it I knew all about my upcoming operation & how to deal with the catheter post surgery.  The da Vinci robot surgery is day surgery with overnight stay.

The anaesthetist warned me about my beard…not all anaesthetists like beards!  Hmmm.  He also wanted me to have a pressure test of my eyes.  The surgery is carried out in a head down bum up stance.  They are concerned about damage to the eyes.

Eye test…

I saw my ophthalmologist Celia Chen (North Adelaide | SA | AU).  I have borderline high pressure in the eyes.  However for 3 years the pressure has been static and the other 2 indicators of glaucoma (damage to the back of the eye & blind spots are not evident).  Celia was not concerned about eye pressure wrt the operation & anyway my pressure has reduced since last time…interesting!

First an elaboration on how I got here.

Remembrance Day 11 November 2009 my cancer was confirmed.

In 2006 (I was 51) I twisted my GP Wai Lee NG’s (Prospect | SA | AU) arm to be tested for prostate cancer.  My PSA level was about a 2…all good.

My next test 3 years later returned a PSA level of 6.9.  So off to the urologist Darren Foreman of South Terrace Urology (Adelaide | SA | AU) I went.  Finger up the bum confirmed an enlarged prostate (not unusual for my age) and a lump (not desired at any age).

The next week  I had the biopsy.  My urologist  uses an interesting contraption inserted via the rectum.  It uses ultrasound so he can see where to go, injects the local anaesthetic and takes the samples.  By sample 8 I had had enough, by sample 12 it should have been over…but he took 1 more…or I can’t count!  A few days later there was blood in my ejaculate…nothing in my urine or bowel movements.  All this was normal.

2 of the 12 samples from the biopsy had cancerous cells.  The Gleason score was 7 or 8.

More tests followed, MRI, CT scan and a bone scan.  The MRI showed the cancer clearly up against one side of my prostate with some haziness adjacent indicating it may have burst out or this was just clotting & bruising from the recent biopsy.  The CT scan showed the same.  The bone scan came up with 3 hot spots, 2 in the bottom left rib & 1 in my right shin.  The CT scan showed nothing in the same rib.

Darren Foreman suggested as I was a young bloke (54 is young…yay!) that surgery (particularly robotically assisted radical prostatectomy) would be the best option and referred me to a surgeon within his practice.

The surgeon Peter Sutherland is a guru with the da Vinci robot.  He dismissed the hot spots on the bone scan as I had no other indicators of spread of the cancer.  Arthritis and damaged bones show up as hot spots also.  Surgery was set for 11 March 2010.

I researched the robot vs open cut mining and surgery vs radiation therapy.  I could not get my head around the radiation.  Surgery just seemed so clean.  So I went back to my GP Wai Lee NG  who set my mind at ease by saying that if he were in my shoes he would do whatever Peter Sutherland recommended without question.

So all that was left now was to wait!  Three months!

I wish to bring to your attention the importance of testing for prostate cancer in males once they have reached 40.

Why…because I have just (November 2009) been diagnosed with a cancer in my prostate.

How did I found out?  I started being tested after I turned 50.  I had to twist my GP’s arm to arrange blood testing as I had NO symptoms.  The only test I was having was the P.S.A. count from blood.  Three years on and the enzyme level is high.  A quick trip to the urologist, a quick rectal exam…five seconds it takes…no longer, no pain!  We have a lump.  Biopsy a week later…yes there is cancer.  Then an MRI, a CAT scan and a bone scan…all painless.  Lymph and bones look clear.  Because I am young (54 is young?) best option is surgery.  We have the best gear (da Vinci robot) here at the RAH so in a couple of months my prostate will be a goner.

Blokes…get tested.  Doctor not agreeable?  Find another.  See a urologist.  Partners…make sure your blokes do this.  Don’t wait…if you are 40 or older…start being tested.

More information here…

www.prostate.org.au
www.prostatehealth.org.au