Tuesday, March 26, 2013

So you need a TURP done


If you are male, read this with a thought to your health.  Also, ensure you have handy your stuffed unicorn, soft fuzzy bunny or soft fuzzy kitten in case the detail is too much for you.

So two years ago I had an issue, I was “peeing in morse code.”  Also, my PSA had jumped up from the normal baseline for me of 2.5 to a 7.  This was very much a sign of BPH or what is an enlarged prostate (http://en.wikipedia.org/wiki/Benign_prostatic_hyperplasia.)  Note, BPH in and of itself is not bad but if not dealt with can lead to prostate cancer. So we started a treating with drugs which worked well but after a year it was making me dizzy. So we changed from one drug to two drugs but they were only about 75% effective and inconsistent.

So early in February we needed to determine what was going on inside my body.  Was the prostate causing issues and if so what were they.  Well, I went through a procedure called a Cystoscopy (http://en.wikipedia.org/wiki/Cystoscopy.)  The scope looked to be at least 2 inches in diameter and about 8 feet long;  well not really.  (Please realize this scope is going in through your urethra and looks way too big to fit.)  In actuality it was about ¼ inch in size and about 2 feet long.  They gave me a local anesthetic prior to insertion (no needle thank God) and then inserted the camera and started the video feed on the monitor next to me.  The doctor was kind enough to ask me if I wanted to view pictures but I said “Hell No!”   Via the procedure it was determined my prostate was constricting my urethra and a node of it was encroaching on my bladder both of which were not good.

There were some options; stay on the drugs, try a procedure called TUMT or TUNA which were in office or a TURP (actually a Bipolar TURP.)  (Video of procedure here http://www.youtube.com/watch?v=GmDwPdP-0VA.) The drugs were not working the TUMT and TUNA were not an option for me due to the encroachment, so we went with the TURP.  The TURP involves an overnight stay in the hospital with a postoperative catheter which pushes fluid into your bladder and then lets it out via the catheter. The catheter is normally removed within a couple of days, though some get it removed the day after surgery.

So on Monday, March 11th, I went in for the TURP.  Later that morning I woke up with some minor pain and a 2 inch diameter catheter made of fairly inflexible silicon plastic (again this one was really about 3/8th to ½ inch in diameter.)  Remember it has a tube for pushing fluids in, a tube for fluid extraction and a tube that inflates a balloon in the bladder to hold it in place filled with 35 mls of fluid.  It important to note that catheter cannot be extracted with the balloon in place.  For even more information on catheters see http://en.wikipedia.org/wiki/Urinary_catheterization.

So Tuesday morning, I talk with the doctor.  He says that 20% of the patients go home with the catheter (leading me to believe 80% went home without one.)  So I told him lets play the odds since I did not want to go home with a catheter.  Well, so they remove the catheter (no pain killers;) first they deflate the balloon ensuring all 35 mils of fluid is out and then slowly start pulling.  Now I was told no pain (well on a scale of 0 to 10) it was actually about a 2 and felt very very strange or weird as one of the nurses told me later that day. Next I got to work on trying to urinate which works but now I must be able to empty my bladder three times and then they ultrasound (bladder scan) and the numbers must come back below 200.  Mine after two tries came back between 225 and 350.  The doctor determined I needed to go home with a catheter.  The nurse was told me I was lucky since I was to get a coude catheter which could be inserted much easier.  

Now this catheter was about 2 inches in diameter and 4 feet long.  It looked that way to me anyway.  It was really about ⅛ th inch in diameter and probably about 18 inches long. A nurse with 40 years of experience got the joy of inserting this new catheter into me.  A catheter going in is not as fun as one coming out; a bit of pain for about 30 seconds and yes that same strange/weird feeling except stranger and weirder since something was going into an out hole.  After about 20 minutes of training on how to change from a leg bag to a large bag for sleeping to keep them clean and me free of infection.  

Finally, it is time to go home to learn how to sleep on my back and sleep in my own bed.  I did not mention that I only got about 4 hours of sleep Monday night, with the noise the IV machine was making, along with the hiss of air from the oxygen line and finally I honestly think they design hospital hallways to funnel noise into the room.  I could hear conversations from way down the hall and when walking out Tuesday (since I don’t remember the trip to the room that well) I notice the closest room was at least 15 feet away if not more but I could hear everything.

So now I am home with a catheter, leash filled with urine.  Yeah, I could drink tons of beer and not worry about getting up but there is just a little more to life then tons of beer (Yeah, I know that is heresy to some.)  The big issue is the comfortableness of something hanging out of you and some slight pain.  I learned a bit of humility and gained respect for those that must wear a catheter everyday with no sight in end.  

Finally, Tuesday the following week, 7am, a beautiful morning and I get the experience of taking the catheter out myself.  Yes, I get to cut the balloon line in the catheter, ensure the balloon is empty and then it is suppose to just fall out.  Not!  I had to gently pull it out inch by inch, at least I did not have to put it in.  Yes, there was that strange/weird feeling  and it was just plain weird.  It was out.  The cutting of the balloon line took about 30 seconds, rubber does not cut well even with sharp scissors because you are being extra cautious with the scissors since these sharp items are very, very close to your family jewels.

I'll be posting an update for the Pre-Post-OP appointment and status. See my week 2 update.