My prostate cancer operation - a personal diary


My prostate cancer operation - a personal diary

This is a personal account of my battle so far with prostate cancer. My name is Christian Nordqvist, 53, Editor of Medical-Diag.com. On 26th of March, 2009, I underwent a radical prostatectomy - in other words, I had my prostate taken out. A biopsy had detected cancerous tissue in the prostate. Before that, a routine check-up had revealed higher than normal levels of PSA in my blood. After discussing various options with my urologist, we decided that radical prostatectomy was best for me. There were two compelling reasons for this - I am 53 (relatively young for this type of disease), and I have a family history of prostate cancer.

Wednesday - 25th March

I arrived at the Christie Hospital, South Manchester, England on Wednesday, 25th March, in the afternoon. Before leaving home I went through my list of stuff I had put in a suitcase - toothbrush, toothpaste, pajamas (UK: pyjamas), etc. I had no idea what was coming. Of course, I had read about it a great deal, and even written about it. Nevertheless, no matter how much you write about a subject, it really is only when you go through it yourself that you have a total understanding of what it might be all about. And even then, you only really comprehend from your own viewpoint and experience.

The surgeon, Mr. Ramani, was the only person in England north of London trained to use the Da Vinci Robot. An incredible medical device that in my opinion has totally transformed surgery today.

I had never ever been in hospital as a patient. At the age of 53, the last thing I expected was firstly to have cancer, and secondly to undergo an operation for it. Here I was, this time as a receiver of treatment, and not a visitor.

In the evening I talked to my wife, Maria, on the telephone. We live in Cancun, Mexico. Our youngest son, 15 was settling well at school. We decided it would not be good for him to be away from both parents. As my sister and her family lived a few miles from the hospital we decided that I would undergo (privately paid) treatment in England while the rest of my family, including Maria, stayed in Cancun. Towards the end of our phone conversation the line went quiet. At first I thought that perhaps Maria was distracted by something on television - she tried and did not manage to suppress the sobs. Tears immediately streamed down my face. The most comforting crying I had ever experienced. "Please cry," I said, "It means we love each other and that gives me strength." We cried and then laughed and then cried again. A peace came over us. From that moment I was sure the ordeal before me would be surmountable, there was no doubt.

A nurse came into my room with a smile - a smile which seems to exist in abundance at Christie's hospital. She took my vitals, blood pressure, pulse, and some other stuff. It seemed I was fine and the operation was scheduled for first thing the following morning. For a patient, smiles and phrases like "everything will be fine" work like magic! If you have to accompany a relative or friend to hospital, or you visit them there, remember that being positive and happy really does make an incredible difference.

Later on that evening Mr. Ramani came in to see me. At this point I must mention that in England a top doctor is not called Dr., but Mr. A top doctor in the UK is called a consultant. If your surname is Brown and you are not yet a top doctor, you are called Dr. Brown. When you become a consultant (top seniority), you become Mr. Brown. Mr. Ramani explained to me that according to my MRI scan, my prostate is stuck to part of the bladder and it might be necessary to shave off part of the bladder sphincter muscle in order to get a clear margin. He added that part of the nerve bundle on the right side may have to go, also to get the job done properly - taking out what should come out, the cancer and the prostate. At that point I told him to use his judgment and do whatever was needed to be rid of the cancer. He explained that whatever was needed would have minimal effect on my ability to control urination, and my chances of regaining erectile function were fair.

Another doctor also came to see me. He explained he was part of Ramani's surgical team and he would be assisting during the following day's operation. I asked him a million questions, most of which I cannot remember any more. Basically, what chances there were of me coming out of this clear of cancer. The basic message was that my chances were very good, and if anything were present afterwards, therapies could easily deal with it.

Then another doctor came in. She explained to me that she is the anesthetist in Mr. Ramani's team. I answered several questions, and felt quite reassured. They all came round to see me the evening before the operation and had worked together for a long time.

I explained that I might find it hard to sleep that night - thinking about what was to come the following day - and wondered whether a good night's sleep might be a good idea for a successful operation. I was given a tablet at about 9.45pm and was asleep by 10.15pm.

Thursday - 26th March

I woke up at about 6am and was given a glycerin suppository. They would be taking me to surgery at about 8am, and could I try to empty my bowels before that. The suppository worked and by 7.30am I was ready.

At about 8am two hospital porters came and pushed my wheeled bed through various corridors and elevators to a room next to the operating theatre. During this trip I remembered all the TV programs and films where the patient is wheeled down hospital corridors, but this time it was me! In a room adjacent to the operating theatre, a nurse came up to me and we chatted while the anesthetist attached something to somewhere on my wrist with a tube sticking out of it. We chatted about Jordan, where the nurse came from, and I told her I admired the present King of Jordan's deceased father very much and that he was educated in England….. That is all I remember, until…

…I woke up with three people in front of me. Mr. Ramani, and the two other doctors. "Hello Christian", Mr. Ramani said. "The operation went well and you are now in Step Down." Step Down is a ward in Christie's hospital they take you to immediately after an operation. Ramani grabbed my mobile phone, which I had kept next to me and asked whether he could call anybody for me. "Yes, call my sister and tell her everything went well and tell her to call my wife please." He called and I fell asleep again. The rest of Thursday is a bit of a blur. My sister came round and told me I talked a lot. I don't remember much about what I said. Obviously, the anesthetic had not completely worn off and I was still in junkie talk.

When I woke up again Thursday evening I had an incredible urge to wee. There was a tube coming out of my penis, a catheter, which led down to a bag on the floor by my bed. The nurse explained that my urge to urinate would subside. The catheter goes all the way into the bladder, where a balloon is blown up to make sure it does not come out. The balloon initially makes you think your bladder is full, until you get used to it. I was on a drip, had a band around my arm which would tighten every hour automatically and a screen would show my blood pressure and pulse, a nurse would occasionally come next to me with a smile and some medication for me to drink or a syringe which she would empty into a tube that went to my wrist. I had stockings on that would suddenly tighten every ten minutes or so, and then loosen again. As I said, Thursday was a bit of a blur. I spent the whole night in Step Down, and until about 4pm the next day.

Mr. Ramani told me he did not need to sacrifice any of the bladder muscle, and that the nerve bundles were mostly spared, just a very tiny part of them were lost. At the time I was mildly relieved, as my concern was more on getting better fast. But now, six weeks later, I am extremely grateful to him and his excellent surgical skills.

Friday 27th March

Being in Step Down was great. There are four beds and two nurses sitting at a desk in the middle all day and all night. You get non-stop attention and they really helped make me as comfortable as possible. Various doctors came in now and again, introducing themselves as part of the urology team, and asked me various questions. I was happy, the pain was mild, and the operation seemed to have gone well.

The pain on that first day was much less than what I had expected. The wonder of keyhole robotic surgery is that you lose very little blood, compared to conventional surgery, and recover much faster. I would describe that pain as an abdominal stiffness you might have had if you had done several sit-ups the previous day, plus a bit of mild gastroenteritis. All I had was paracetamol (Tylenol) and that was fine. Stronger painkillers were available, but I really did not feel that much discomfort. I noticed that coughing was painful, but the nurses were incredibly helpful. They showed me how to hold my stomach with both hands, firmly but not too much, before coughing - that made an amazing difference.

Saturday 28th March

On the following day I was back home. A total of just two nights after the operation at the hospital. Compare that to the ten to fourteen days' hospital stay conventional surgery would have required. Having the urinary catheter was a nuisance, but that was all - a nuisance. It was not painful and I was able to walk down the road, up the stairs, etc. with ease. My sister made me something to eat and we chatted for a while. She offered to spend the night but I told her I was fine. As soon as I was on my own I realized my whole outlook on life had changed. I was now on the other side of the bridge - the operation was over. Months of worry about my future, my chances of a normal lifespan, etc., were gone, and replaced with what I would describe as one of our most basic instincts - living…surviving. It is an instinct that in its purity is beautiful and incredibly powerful!!

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I will soon write about the following four weeks, including the removal of the catheter, the histology report, etc. As soon as I have written it, a link to that article will appear here.

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