Prostate problems for Beekeepers of a certain age

I've been suffering prostate problems for a while now and am due to have surgery on the 9th of February. All hives were treated with OA at new year and have hive cozy's on so the bees should be fine until the start of the season.

 

[BKF Admin]

Good luck with the surgery John
You should be able to sleep better once sorted.

 

[Gilberdyke John]

Well the surgery went well. I knew nothing until someone kept pestering me to wake up in the recovery room. As they wouldn't stop until I opened my eyes I reluctantly complied but drifted off to sleep again.
A while later I awoke in a bed in the high observations ward attached to various sensors and pipes and with a morphine driver connected. I'll say this, I didn't suffer pain just a bruised feeling for a few days.
Pain control was highly effective and gradually transferred to oral dosing, and reduced to 2 paracetamols 4 times a day then as required until none.
I was slightly dismayed to learn I would have to self inject Fragmin anti clotting agent for a month but hey beekeepers cope with maximum prejudice injections on a regular basis.
Post op I was on a course of antibiotic injections but somewhere along the line I developed an infection which wasn't covered by the stuff I was on and my temperature went up. Cue a series of blood tests and culture samples before being placed on a different antibiotic which nailed it. This did mean I was kept in an extra five days but once I recovered my sense of taste the food was good so no worries.
Some of the early pain control caused constipation which eventually yielded to lactulose but that's another story.
With the extra time of incapacity I was sentenced to a longer period with the catheter in and have an appointment for it's removal on Monday morning. Then I'm told it takes a while to retrain control so I should wear tena men pads and not laugh uncontrollably or things might be messy.
After 3 months I go for a PSA blood test and it should be almost zero by that time. Fingers crossed but confidence is high.
I've been thoroughly warned not to try to lift anything so I'm working on a maximum load of a mug of tea or a plate of food for a few days
Updates to follow.

 

[lakelander]

thanks for this. May be facing a similar thing shortly. Could I ask how long, before you can drive?

 

[Gilberdyke John]

Hi Lakelander. I aren't allowed to drive for 8 weeks from the date of the operation. Some say this is because of the anaesthetic after effects but to be honest I didn't ask. My wife and son are both named on my insurance policy and I think the main problem might be getting my car back when the time comes

 

[lakelander]

Hello John
once again thank you for your blog and your reply. I go for my consultation with the surgeon on the 19th. As I am not suffering any symptoms. I am hoping for a watchful wait even if it just the two years before retirement!
I shall follow your blog with interest
You may be right about the car.
Regards
Stephen

 

[Gilberdyke John]

An early start this morning as I had to be in Scunthorpe hospital for 8 am. The plan was to have my bladder scanned followed by removal of the catheter. It was interesting to watch a contrast dye passed back into my bladder via the catheter. Sadly my surgeon wasn't entirely satisfied that the time for catheter removal was today, pointing out that the risk of narrowing of the urethra during healing would be much less if the removal was deferred for another week.
He's the expert so I am now booked to go back next Monday for the removal.
It was reassuring to discuss a few items I have experienced since being discharged from hospital and being assured everything is entirely normal. (occasional specks of blood in the catheter tube and leakage of a few drops of urine around the tube when I use certain muscle groups).
I'm taking a bit longer than I expected to recover, not desperately so but I'm pleased that I opted for surgery at the earliest opportunity while I am still fit enough to fight off the adversity. I also opted for traditional access via an incision between JT and navel rather than keyhole access or robotic methods. The wound was inspected today and is healing nicely.

 

[Gilberdyke John]

Update - Yesterday saw the final self injection of the course of Fragmin anti clotting agent (hooray!)
I returned to the hospital this morning for removal of the catheter. This was a simple matter of the nurse deflating the anchoring "balloon" and telling me to breathe in. While doing this she had drawn it out. A strange sensation sort of a scratchy intense tickle
As I had had the catheter in for an extended period the sphincter remained open and I was kitted out with an incontinence pad with cotton knickers. The procedure required me to stay in the unit for the day so my fluid intake and output could be measured. Measuring the output proved difficult as standing up to take my jug to the head invariably led to emptying my bladder into the pad. This was overcome by changing to a clean pad and weighing the soggy one - simple!
By mid afternoon the assessment was close enough to balance and I was discharged to home
The incontinence may settle fairly soon or it could take a number of days, weeks or months during which I will have to wear pads. Either way what will be will be and the cancerous prostate is no longer within me.
Hopefully I have provided some reassurance to other male beekeepers of a certain age.

 

[lakelander]

thank you it has been reassuring and informative

 

[Gilberdyke John]

The incontinence is quite messy as I found the pads I had been given rapidly filled up and then leaked. A bit of googling led me to the Age UK site and an advice line. It transpired that a wide range of capacities are available even up to 3litres. Obviously it would be difficult to walk if one of those was allowed to fill up. It would be pretty hard to walk with 3 kilogram weight in your pants
Anyway I ordered some capable of holding 1.5 litres if necessary and will change them before they get too heavy.
Just one of the bits of post op experience you find out by living it.

 

[Gilberdyke John]

14th March - a routine follow up with my surgeon. He informed me that following the removal of my prostate it had been sent for investigation. This had revealed that the tumour which was present and known to be aggressive actually had contained an even more aggressive centre. The fact it had been removed in its entirety proved the decision to remove it was entirely correct.
We discussed my current incontinence and he assured me that this was quite normal.
I will be sent an appointment for another consultation around three months after the surgery and I will have to go for a PSA blood test a few days before attending. Also I will have to undergo periodic PSA tests for the rest of my life. This is reassuring and I have no problem with providing a regular blood sample.

 

[Gilberdyke John]

1st April update. I am still incontinent but things are slowly improving. I can hold urine in while sitting or lying down and for a short time whilst walking. Wearing the pads allows me freedom of movement and this has allowed me to build up my strength and stamina again. I'm still careful about lifting things but the external scar has healed nicely and begun to fade. I get an odd twinge or two in my lower abdomen which I am told is normal and just a symptom of things knitting together and healing.
I have found that the Boots Staydry Maxi Plus pads are convenient and have an adequate capacity to cope at 3 changes a day. Priced at £3.75 for ten but presently on offer at 2 packs for £4 so I have laid a stock in just as I do with wax foundation when on offer
I am going to start driving again soon, probably just a couple of short trips to begin with although to be honest I have become quite used to being taxied about by Mrs J.

 

[Gilberdyke John]

10th May I should be hearing from the hospital soon for my 3 month appointment. i will have to go for a blood test a few days before the appointment so a PSA test can be done. The result should be almost zero by now. I will have to have a chat with the surgeon as I am noticing a progressive reduction in flow rate that may indicate thickening of scar tissue at the exit from the bladder where the prostate was removed and the urethra reattached. We'll see what he says but it might need dilation.
I am slowly getting better shut off control and retention but I do find my incontinence pads are damp after a few hours. This has led to a problem with "jock itch" so I'm going to see my gp for some anti-fungal/steroid cream to sort it out. When I first noticed an irritation I thought of nappy rash and used Sudocrem which every mother knows. I suppose the warm, damp conditions inside the pad are ideal for the problem to develop, especially as the summer is progressing.

 

[Gilberdyke John]

16th May - I attended my three month post op consultation with my surgeon. My blood test PSA result was 0.015 ie basically zero so confidence is high that the cancer is gone. However I am booked for regular monitoring blood tests for life. No problem!
We discussed a couple of items, shortening of JT which results from the removal of the prostate and drawing together of the ends of the urethra and bladder outlet to close the gap. There are options for this ranging from tablets (cialis), injections or a vacuum device. I'm prescribed a low dose of cialis to see how it goes.
I've also noted a progressive reduction in flow rate. This is something which occurs in a small proportion of cases and is due to thickening of the scar tissue around the internal join. It's a simple procedure to stretch the offending tissue and I await an appointment in the next week or two.
The progress of recovery of continence is following a reasonable pattern. I am dry while lying down or sitting, dry while standing and walking slowly, dribble a little when rising from seated to standing up and dribble a little under exertion such as lifting. (no problem with empty hives but someone else will have to lift full supers).
All in all I'm delighted the problem was caught in good time and the operation was a success. Score one for my surgeon and the team!

 

[Gilberdyke John]

I'm not getting on with the cialis. Side effects which have emerged are back and neck pain, aching joints and splitting headache. Apparently these affect about 10% of patients. First couple of days I thought the aches and pains were just a bit of an off day but last night I could hardly move my back or neck. As the medication is wearing off so are the symptoms. I've discontinued taking the tablets until I see the consultant again.

 

[Gilberdyke John]

8th June - restriction clearing job
Spent a long day in Scunthorpe Hospital. No food/drink from last night Set off from home at 6am to be booked in the urology surgical ward. Then waiting my turn for the procedure. Went into theatre preparation about ten am where I was fitted with a canula, given antibiotic, pain relief and finally sent to sleep. The procedure involved internal urethra and bladder camera inspection followed by trimming off the thickened scar tissue causing the obstruction. I woke up easily in recovery room wearing a catheter and was able to slide myself across from the operating table onto my bed, given a ride back to the ward at 11am where my dentures and glasses were waiting for me.
The procedure was painless but I had not been included on the lunch list so I was provided with Nato standard tea (milk, two sugars) and once it was seen it stayed down I got toast, butter and raspberry jam Through the afternoon I drank copious amounts of water as the blood cleared from the catheter tube until it was the usual pale yellow stuff. I had juice followed by tuna salad for tea with fresh fruit pudding. A visit from my surgeon and approved for discharge
My wife came and collected me and I am now home again.
Catheter removal due in ten days so wearing my trusty leg bag until then. I will have a wander down to the apiary tomorrow to report progress to the bees.

 

[Gilberdyke John]

20th June - removal of catheter and taught to self catheterise
Following the obstruction clearing procedure I have had a catheter in while the "pruning" healed. This second spell with a catheter has been an unpleasant period. The tube was slightly shorter than the first time, resulting in the leg bag putting tension on the catheter when I bent over, sat down or even walking if the elastic strap worked its way down my calf. Over the period it caused the tip of JT to become quite sore. This may not have been a problem if I had been less tall.
Immediately the catheter was removed I had relief from the irritation.
As previously I had to spend the day on the ward to monitor water intake /discharge balance.
On completion I was handed over to the urology nurses team and taught how to self catheterise. This is to ensure that the continued healing of the urethral scar tissue does not close down again, causing another flow restriction. I was somewhat apprehensive about this but (pleasantly?) surprised to find it relatively painless and simple.
An "interesting" day and I was home again in time for tea

 

[Gilberdyke John]

29th August - Following on from my last entry and the adverse reactions to the cialis I was referred to a vacuum device specialist. He explained that the shrinking was due to lack of natural erection when the prostate and adjacent nerve tissue was removed. No erection meant no blood flow boost and things shrink. I've been prescribed a unit for daily use to keep things right.
I've also had a blood test which gave miniscule PSA result. Another one in a few months.
I'm still carrying out intermittent catheterisation and dare I say it it's become a simple routine. I'm now on my second box and when I get down to about ten in the box I phone the supplier to have another box sent to me.
Continence is slowly but steadily improving. Most days I put a fresh pad on at bedtime and it's still fresh in the morning. Through the day I have to be conscientious about regularly visiting the toilet and the pad lasts through until bedtime again albeit I might have a bit of dampness in it by then. Walking slowly allows me to keep control whereas too quick and I leak a bit still.
I've even ridden my horse a few times and I'm back to Beekeeping so life is good

 

[Gilberdyke John]

10th October - another problem which may or may not be related.
I developed a bit of infrequent blood when wiping after passing stools. As per the tv advert I told my doctor. Cue a lubricated finger and a referral to the hospital as I am now regarded as having a history of cancer and carefully watched. I had a preliminary visit a couple of weeks ago and am booked in for a colonoscopy tomorrow morning. This requires me to be thoroughly "emptied out" so preparations start today and I shall be taking some pretty powerful laxatives this afternoon. It's going to be an interesting evening

 

[Gilberdyke John]

Colonoscopy completed. The procedure is best described as uncomfortable but tolerable. Results were that I have some interior piles which account for the intermittent blood in my stools. I also have symptomless diverticula which is common in older people. No polyps or other abnormalities.
Advised to maintain a healthy diet and drink plenty of fluids to avoid constipation.