On 11th May 2013, Newstalk radio broadcast a documentary about the changing role of men in Irish society. It examined several features of life for Irish men, including erectile dysfunction, which affects some survivors of prostate cancer like Jim Scott of Men Against Cancer and myself. This is an extract of the documentary, where Jim and I talk about one of the side-effects of our treatment for prostate cancer:
When Movember asked me to participate in a photo shoot to promote the campaign I was naturally delighted to oblige. I didn’t know they were going to make a video as well but here it is. Please support my own Movember efforts at http://mobro.co/TomMolloy. Thanks!
Do you despair at the commercialisation of Christmas from November? Well, spare a thought for us prostate cancer patients and survivors. When diagnosed with prostate cancer, we start to read up on it and regardless of where you get your information, the first thing you learn about a prostate gland is it is “about the size of a walnut”.
So imagine what it’s like not being able to enter a supermarket without being taunted by displays of prostate-sized bags of walnuts everywhere we look!
And I used to so enjoy a nice Waldorf salad!
Two months have now passed since getting the good news that my radical prostatectomy was a success. It has been a time of recovery where I, frankly, grew weary of talking about cancer, preferring instead to focus quietly on the gradual improvement in my post-operative condition. It was a slow process during which I thought not about cancer but of approaching Christmas and a new year. Believe it or not, cancer gets pretty boring after a while, even when it’s up-close-and-personal.
It may be easy for me to say that because my brush with prostate cancer has been mercifully brief and moderate compared with most patients’ experience. I can say that now, without fear of tempting fate. I just had my first quarterly test and I’m still in the clear. The test is basically a PSA test, where it should be zero or very close to it. Mine is less than 0.08, which means it’s too low for the lab to detect. That is exactly what I wanted to hear!
Between giving a blood sample for the test and getting the result, I had mixed feelings. One the one hand, I felt generally well (all things considered) and was optimistic of getting a good result. On the other hand, I couldn’t help thinking about the period between my biopsy and D-Day, when I also felt optimistic but still got the worst test result ever. Complacency is a mind-killer to my mind and my late mother felt great after a year of remission, just before her cancer made a lethal return. So the week between giving my blood sample and getting the result was a tricky one. In my heart, I felt I was in the clear but there was – and, I suppose, always will be – a little, stoic voice inside my head warning me not to take anything for granted.
Contrary to what you might expect, I have not spent long hours late at night Googling cancer, alternative treatments or ‘living with cancer’. I’m actually happy enough to take what my doctors and nurses tell me at face value, if tempered by my own experience and common sense. The experience has been broadly in line with what I was told to expect. The only exception is a great one – that I don’t have an issue with urinary incontinence. Apart from that, I’ve been pretty much a textbook case and I can’t say I have any complaints.
The only complaint I might have is somebody starting a rumour in my home town of Carrick-on-Suir that I had died. The same thing happened when my mother was still alive but severely ill, in St. Brigid’s Hospital in Carrick. There are some people in this world who are so desperate to be the first with bad news that they cannot wait for the sick to die. So they just make up a story and the lie grows legs and spreads, often to the distress of the sick and their families.
Sadly, this is not unusual in my home town and I’m only the latest to join the ranks of Carrick-on-Suir’s walking dead. Thankfully, one of my best mates there had the presence of mind, on hearing ‘the news’ to ring me directly to verify if it was true or not. Eoin is the archetypical ‘bloke’, meaning he doesn’t pick up the phone unless it’s a matter of life or death (or, more importantly, work!). In this case that was literally the case, when I saw his number come up on the phone and the first thing he said was “Tom, thank god you answered!”. I was glad that Eoin had the good sense to do this because it gave me a chance to phone my sister, Maria, and tell her to be ready for people offering their condolences. Sure enough, that started within a couple of hours, on the school run.
In a way it’s kind of funny and it would have been even better if it could have gone as far as a funeral, where I’d be in disguise in the background, noting who was there and who wasn’t! On the other hand, it’s really not funny at all and I am still quite pissed off about it. Not at those who only repeated what they heard, there’s nothing wrong with that and it’s how community works. But in each of my mother’s and my cases, one particular individual was the first to say “Rita Molloy is dead” or “Tom Molloy is dead”, knowing full well they didn’t know it for a fact. That is the fucker I would like to meet!
Notwithstanding all that, when I visited Carrick around Christmas, I had a good old laugh about it with my mates. The inevitable jokes about ‘The Resurrection’ and ‘Dead Man Walking’ gave rise to much hilarity in the pub. That was a great night actually, one of countless many in my home town and, I expect, not the last.
Truth be told, I was starting to get a bit too accustomed to the sick-leave lifestyle, getting dressed for lunch and spending way too much time surfing the web. As my recuperation period extended into December, with Christmas and my return to work approaching, thoughts turned to life-after-sick-leave. I had finished up on my previous project just before going into hospital so I wondered what my employer would have in store for me in January.
Most men who survive prostate cancer return to work on a part-time basis initially, keeping the workload relatively light. However, most prostate cancer patients are approaching or past retirement age so it’s no big deal for them. At 44 I am but a cherub with another 24 years of whoring myself out to clients and servicing a negative equity mortgage while being given a jolly good ass-fucking by the Irish government at the behest of its masters in the IMF and Europe. And I thought being diagnosed with cancer was bad!
Anyway, being a project manager, part-time working is not really a viable option for me. I had hoped that the next project would be a nice cushy number for me to ease back into the land of the living with. Yeah, right!
One thing that has changed since being diagnosed and treated for prostate cancer – I don’t sweat the small stuff any more. I think this makes me better at my job. Like so many techies who go into more management roles, I found it hard to let go of the technical minutiae, resulting in micro-management and stress.
No more! Time is so much more than mere money. There is no honour in working insane hours and neglecting your family as a result. If you find yourself doing that, you’re doing something wrong! Hard work is a good and noble thing. But if you work hard for its own sake and little return, you need to reappraise your priorities.
Your family and close friends are the most important people you will ever meet. Look after them – they are the ones you will depend on in your hour of greatest need.
11/11/11 – is a date that will long be remembered in the Molloy household. While Michael D. Higgins was being inaugurated the ninth President of Ireland, I would be getting the post-op pathology results and having my catheter removed. The pathology results were first and the news was good – the surgery got all of the cancer. Welcome news indeed! Inasmuch as I can be after a cancer diagnosis, I am in the clear!
Of course, once you have been diagnosed with cancer you can never be completely out of the woods. There will always be a risk that cancer will rear its ugly head again in the future. It’s something I will just have to live with – this is as good as it gets. Considering I had at one point been resigned to dying in the not-too-distant future, the result is pretty damn good! I will have to return to the Rapid Access Prostate Clinic in the Mater Hotel every three months initially for check-ups, basically monitoring of my PSA levels. All going well, the frequency of the checkups will reduce to 6-months then annually.
Following all this good news, the next order of business was removal of the catheter. I had been looking forward to this since Cathy was installed during the surgery. However, it was not as straightforward as expected. Normally, removing a catheter is quite simple. The business end is held in place in the bladder by a balloon filled with water. The water is removed by means of a valve outside the body and the catheter slides out. That’s the theory.
In my case, which was rare, the catheter would not budge. It was perplexing so I was sent for an x-ray and an ultrasound to see if the balloon really was deflated or whether an obstruction could be identified. The balloon was deflated all right but it was not clear what was preventing the catheters removal. This was disheartening. Cathy could not be forced out because, quite apart from the intense pain, there would be a risk of damaging where the two ends of my urethra were joined together, where my prostate gland used to be.
Later in the day, I had been walking around a bit with the balloon deflated. So another attempt was made to remove the catheter. By now the tip was outside my bladder and somewhere in my urethra. The trouble was, it would not go back into my bladder – it was stuck! While unusual, this situation was not unheard of. If I went home for the weekend as I was then, with a bit of luck, the catheter might work its own way out of my urethra and penis. If not, I would have to go to theatre next week to have it removed under anaesthetic.
By now I was very sore and found every movement extremely uncomfortable. The journey home was littered with speed ramps and potholes to maximise my discomfort, despite TLC’s best efforts to find the least winding and bumpy route. On getting home, the good news from the pathology results was overshadowed by the prospect of another few days with Cathy and another night in hospital. I was feeling quite dejected.
I went into the bathroom and closed the door behind me. I was going to examine this for myself. Very gingerly, I took hold of the catheter and applied gentle outward pressure. It came out of my penis, by about half an inch, without too much difficulty. So I tried another half inch. It gave way all right but this time it was painful. Crucially, though, I could not discern any increased resistance to Cathys outward passage. Assuming there was no physical obstruction to the catheter coming out, it could be removed but it would hurt. The challenge would be to maintain focus on the amount of resistance to the catheters removal while not being distracted from this by pain. If resistance increased it would indicate a physical obstruction, necessitating a mission abort to avoid doing damage. This meant I would need to stop pulling immediately if resistance increased which, in turn, meant I’d have to pull the catheter out slowly.
The decision was made. I gritted my teeth and braced myself. There was about five inches of catheter to remove so without wasting any more time thinking about it, I got on with what had to be done. It hurt like hell but the desire to get Cathy out without tearing my urethra to pieces prevailed over the pain. My focus was entirely on how smoothly the catheter emerged from my penis. Through a kind of out-of-body screaming, I could feel Cathy scraping the inside of my urethra but not hitting any obstacles. Just as I was beginning to wonder if I was doing the sensible thing, the end of the catheter dropped out of my penis and I threw it into the sink with a vengeance. Success!
That was one of the hardest things I have ever done but having it behind me now felt great. I was thoroughly fed up with Cathy and did not want to spend another minute with a bag of piss strapped to my leg. I would not recommend this approach to anyone else as it is risky and it could have ended in tears. But in the interest of getting rid of Cathy once and for all, I decided it was worth accepting the risk and the pain.
Within the hour, I had my first normal pee in over two weeks and it felt good! Well, it felt more strange really but that was to be expected after what my body had been through. Surprisingly, there was no blood – just some stinging and a slight ache.
That was not the end of the good news though! I had left the hospital armed with a two-week supply of urinary incontinence pads. I wore them for the first two days but it quickly became apparent that I do not need them. I cannot believe my luck – no urinary incontinence! Well, I still leak a drop or two if I try to force a larger than usual fart. But that’s nothing. The main thing is, I don’t need to wear pads. The usual suspects of coughing, sneezing or standing from a seated position do not present any problems at all for me. I will still do the pelvic floor exercises as that muscle will still have to do more than it is used to, since I lost a sphincter muscle in the surgery and don’t plan to stop farting. Incontinence was the post-op side effect I was least looking forward to dealing with. That it is not apparently going to be an issue is a most unexpected bonus and yet more to be grateful for.
Another thing I left the hospital armed with was a prescription for Viagra. This is, alas, a necessity. Suffice to say, I do indeed have erectile dysfunction as a side-effect of the surgery. It is treatable though and, I hope, temporary. I am to take 25mg of Viagra each day for six days and, rather biblically, “on the seventh day” I take 100mg. All going well, that will enable me to have an erection. This is not just for the purpose of l’amour though. The Viagra regime is necessary to increase blood flow to the penis, to prevent scar tissue building up which would eventually make it impossible to achieve an erection.
All things being equal, if I had to choose between being stuck with urinary incontinence or erectile dysfunction, I would have chosen the deal I have now. So overall I am very pleased with the outcome of my treatment to date.
It behoves me at this point to express my eternal gratitude to the medical and nursing staff in The Mater Hospital, the Irish Cancer Society, the ARC cancer support centre in Eccles Street and, of course, my family and friends (old and new) for all their wonderful support.
With a successful result to the treatment (notwithstanding the ongoing ED issue) it is time now to move on and rebuild my life. Between sick leave and burning up my annual leave entitlement for the year, I do not expect to be back to work until the NewYear. I will need that time to fully recover. I am still quite sore and I tire very easily. There is also the matter of how I spend the rest of my days. Having stared into the abyss at a relatively tender age, I do not see a resumption of ‘business as usual’ in January as a viable option. Exactly what form the changes take I do not know yet. But there will be changes.
The day after I was discharged from hospital was the first of Movember, when men around the world grow moustaches to raise awareness of prostate cancer and to raise funds for it’s treatment and research. I am, of course, taking part and if you would like to show your support you can do so at http://mobro.co/TomMolloy.
I had my first experience of urinary incontinence last night. It came not from coughing, sneezing or standing up as the literature would have you expect. For me, it came from farting. Twice! I had noticed over the past few days, a small dribble of urine from where Cathy (the catheter) enters my penis, when I had a bowel movement. At first it was exceedingly uncomfortable but at least it was confined to times of defecation. Over the days the discomfort of this slight dribble diminished but now, it seems, it is no longer confined to the throne.
This is the start of it – urinary incontinence. Cathy probably held it at bay to some extent but today is my last day of wearing a catheter, thankfully. It has been a very long two weeks since my radical prostactomy. The pain, discomfort and diminished mobility have all been tough going, though improving slightly each day. Wearing a catheter is a damn nuisance and somewhat demeaning, especially at night when you have to hook up a second bag to take the 1.5 to 2 litres passed during sleep.
Cathy is a necessary evil, however, to allow the urethra time to heal from the surgery. The urethra is a tube that carries urine from the bladder to the genitalia and outside the body. It passes right through the middle of the prostate gland. A bit of a design flaw there, methinks! When the prostate is to be removed, the urethra has to be cut on either side of it and the ends joined together. Obviously, if urine continues to flow over the wound it would not heal. Hence the need for a plastic tube to temporarily take its place, inside the urethra. So urinary incontinence is not, in my case, a product of prostate cancer per se but a side-effect of the treatment.
The good news is Cathy goes tomorrow and I will be able to pee normally again. Hooray! I will also be able to resume the pelvic floor exercises, which had to stop while I’ve been wearing Cathy. I’m going to need them too, now that incontinence is a reality. One person who will not be too put out by my incontinence is TLC, who no doubt will derive some satisfaction if pissing myself is to be the penalty for farting. It is TLC’s silver lining and I don’t begrudge her. I’ve had the joy of morphine and tramadol so now TLC gets to enjoy some peace and quite and clean air.
I am still quite sore from the surgery, though it is getting gradually better. I can get in and out of bed more easily now than two weeks ago. Mornings are the worst part of the day because the medication has worn off during the night. So I have the unpleasant routine of emptying Cathy and disconnecting the overnight bag before I go downstairs and take my meds. That’s the first order of business every day. I was never one to pop pills for every little complaint, trusting my body to repair itself when necessary. But even I must concede that pharmaceuticals are necessary at times like this. I have quite the little array of tablets to take in my morning routine.
One of them is an antibiotic I started on this week, due to a suspected bladder infection. On going to my GP, a urine test showed up a lot of white blood cells, confirming what I had thought. For several days I had the increasingly persistent feeling that I needed to pee. Despite Cathy taking care of that for me, the sensation kept getting worse. It was like when you stop urinating mid-stream and try to hold it. Well, that’s what it was like for me all the time. It was horrible, with no prospect of relief. Thankfully, though, the antibiotic sorted this out within a day and it has been much more tolerable.
Cathy’s removal will mean resumption of the pelvic floor exercises I had just started a week or so before surgery. I got more information about these exercises from a physiotherapist at the prostate cancer conference I attended at the weekend. For one thing, they don’t involve any lying on the floor – ‘pelvic floor’ is the name of the muscle itself. Everybody has it and it’s like a sheet of muscle across the bottom (or “floor”) of the pelvic region. What this muscle does is basically supplement the sphincter muscles that were on either side of my prostate gland. I lost one of those in the surgery so the pelvic floor muscle needs to be trained to take up the slack. My relatively young age should be in my favour as I train my pelvic floor muscle to take over the duties of a sphincter. With time and training, hopefully it will become second nature and I will have no issue with incontinence after a few months.
Losing Cathy is a major milestone in my treatment and recovery. It marks the healing of my urethra and near resumption of normal urinary service. It also marks the beginning of the serious work of rehabilitation. My daily walks have been hindered to a large extent by Cathy, so they will be longer and more vigorous. As the 4” wound on my abdomen heals, I will soon be able to resume weekly yoga classes in the ARC cancer support centre in Eccles Street. In the meantime, the pelvic floor exercises I had described as “tedious” before the surgery are now anything but, since the reality of urinary incontinence has begun to kick in. Motivation will not be a problem there!
It’s a week since my radical prostactomy, my fourth day at home and I have settled into a routine of sorts. What occupies my mind most is pain. Ironically, it is not so much pain from the surgery as that from a different operation, over four decades ago.
When I was one or two years old I had surgery for a hernia. I have no recollection of it, just a long scar on my abdomen, to the left of my brand spanking new scar. My abdomen is still swollen following my prostatectomy but it is very lop-sided, with most swelling on the right. It seems that 42-year-old scar tissue is not as flexible as ordinary skin and muscle. There is a pronounced dimple along half the length of the old scar, where tissue is being pulled and stretched, resisting the swelling and causing considerable pain as a result. If it were not for this, I would actually be relatively comfortable. It’s just my luck that something which never bothered me before flares up now! Hopefully, when all the swelling has gone this issue will go with it. But I have an awful dread of needing further abdominal surgery at a later date.
Pain in around the prostactomy wound is worst when I laugh, cough or sneeze. The pain hits me in the whole abdominal area on these events but sneezing the worst. I feel a strange sensation like a burst of heat within the wound when this happens. It only lasts a second or two but the stinging pain in the old scar area continues for several minutes afterwards. I have become adept as suppressing sneezes but if there’s one in there it has to come out sooner or later. The knowledge of this and the anticipation of it is terrible. I like to think I have a pretty high pain threshold, making a distinction between pain and tolerable discomfort. This is definitely pain and it knocks me for six every time. If this is what a caesarean section feels like, I have a renewed respect for TLC and other women who’ve had sections. It is no joke, I can tell you!
Coughing causes the pain as well but it’s not as severe and I’m getting used to controlling it. The first thing to cause coughs are phlegm in the lungs. I’m like a cat bringing up a furball now, coaxing it out gently instead of ejecting it decisively. I’m sure it’s not a pretty sight or sound and it must be testing TLC’s patience. It still hurts but not as much. The second cause of coughing is something hitting the back of my throat. This is as bad as sneezing and is caused by the most innocuous things like eating toast! Yesterday, I must have been inhaling as I raised a slice of toast to my mouth and a crumb came off it and hit me where it hurts, causing an involuntary cough I wasn’t ready for. I nearly went through the roof!
Laughing causes pain too but it’s the kind of pain you don’t mind so much. It’s like trying to suppress a laugh at a funeral and is all the more enjoyable for it, in a perverse way.
Thinking about it now, I’m attending a national prostate cancer seminar tomorrow and the first workshop I’m registered for is ‘Laughter Therapy’. Maybe that wasn’t such a wise choice, nine days following major surgery. What the hell! It’s the one I wanted to go to so I will. The full day seminar will be my first big excursion from the house since leaving hospital and I’m a little apprehensive about it. Taking my meds on time and getting to drain Cathy (my new name for my catheter) will play on my mind somewhat I expect. But I’m sure there will be many like me there, though probably not as soon after surgery.
On my second day home from hospital this week, I received a letter. It was from the hospital, informing me I have an appointment with a consultant breast surgeon! This was either an admin error or someone was taking the piss! On phoning the breast clinic, it transpires I do indeed have an appointment for a breast check, of all things. Apparently, men can get breast cancer as well. This was news to me and what a way to learn it! Wouldn’t that just be the cherry on the fucking cake, if it turned out I had breast cancer!
In my last hour in The Mater Hospital, I had a bit of time to kill before TLC would arrive to bring me home. So I went for a stroll through the hospital corridors, for much needed, post-op exercise. I paused at a window overlooking Berkeley Road and saw runners in the Dublin City Marathon passing by, many of them clearly running to raise funds for cancer charities. This had a sudden and entirely unexpected effect on me as a multitude of feelings came flooding to the front of my mind. These were feelings I subconsciously felt the need to put on hold while I dealt with the business end of having cancer.
I knew that many of the people running the marathon for cancer charities were doing so because they had recovered from cancer themselves or had lost loved ones to the disease. They were people like me, who had lost both my parents and came very close to falling victim to cancer myself.
It was only through sheer luck that I was diagnosed when I was. My combined PSA and Gleason scores were bad, initially indicating I might not survive. But the long anticipated MRI and bone scans results showed that – against the odds – my cancer had not spread beyond the prostate gland. Prior to getting those results, I was mentally bracing myself to be told I was going to die from this. But I had major surgery ahead of me so I still could not unwind.
Now, packed and ready to go home after the surgery, I stood at the window watching people running a marathon on behalf of people like my late parents and me. For the first time since D-Day, overcome with emotion, I cried.
That window, overlooking the corner of Eccles Street and Berkeley Road, represents to me a turning point in my life from where nothing can ever be the same again. I am going to die. That is an absolute certainty. What is unknown is how or when. Every minute between now and then is a gift not to be squandered.
Well, the deed has been done and I am now sans prostate. The last thing I remember before surgery was the anaesthetic being administered at 1pm and thinking about my late parents. It was upsetting to think of my mother and father dying from cancer as I was about to be operated on for the same disease. So I had to make a conscious effort to not think about my parents at the most vulnerable time of my life. That was hard.
When the welcome oblivion of general anaesthetic lifted, I noticed the time: 10pm. I was initially troubled about the length of time I was out – it should not have been nine hours. Apparently there was some issue with my pain management: I vaguely remember regaining consciousness briefly and being in some distress in the recovery room but quickly going back under again. When I came to at 10pm I felt no pain but I was disorientated.
I had always imagined that coming out of a general anaesthetic must be very disorienting and I was right. Losing several hours is disconcerting, not that I would want to have gone through them. After spending a couple of hours under observation in the recovery room, I was brought back to the ward, where I had the best nights sleep in weeks!
On waking the next morning, I was pleased to find I had a patient controlled analgesia attached to my arm – the means by which I would treat myself to frequent doses of morphine for the next day and a half. I had heard great things about morphine and was not disappointed. As well as being an effective painkiller, it gives you a pleasant ‘high’ – the silver lining of major surgery!
The next thing to check was my abdomen and, of course, Horace. Poor Horace! The catheter was in place as expected. What I was not ready for was the sight of a 6mm diameter tube sticking out of his one eye! It looked awful and Horace was horribly bruised and swollen. Surprisingly, though, the catheter did not feel as intrusive as I had expected (probably due to the painkillers).
The day following surgery was okay, thanks mainly to my new best friend: morphine. Getting in or out of bed demanded herculean effort but apart from that there was no pain. I mostly spent the day stoned and drifting in and out of sleep. The medical team was around early and Dr. Galvin told me the surgery had gone well. He managed to remove all that he needed to while leaving nerve endings to the right of my prostate largely intact. It is these nerves I will rely on to achieve an erection, eventually. I needed a lot of pain medication during surgery so that accounted for my feeling so out of it now. Dr. Galvin said I would be coming off the intravenous morphine the next day and switching to an oral version. Apparently the good stuff can cause constipation and the next signs of recovery the team will be looking for are farting and shitting!
Grace was to come in to the hospital to see me the next day so I was happy enough to abandon my NBF in the interest of having a clear head for my daughter’s visit. I was a little worried that she may be freaked out by seeing me laid up, with tubes sticking out of me and me carrying a bag of my piss around like a macabre handbag. As always, though, Grace was cool about everything. There is an old head on her 6-year-old shoulders and she seemed barely even curious about my condition, thankfully.
I started walking around the hospital more, on Dr. Galvin’s advice. I’m a bit shaky on my feet and get weak and dizzy easily. So trips are kept short and close to the hand rails that are everywhere in hospitals. I’m also to drink as much water as I can, to flush out the system. Luckily, I can drink quite a bit so the nurses are kept busy emptying my catheter. I have to say, I really do not like wearing one! While it wasn’t particularly uncomfortable at first, it is starting to get so now and I am counting the days to Friday 10th November, when I get it removed.
I said it before and I’ll say it again – you’d be amazed what you can be grateful for. Even something as routine as taking a piss is a thing of great beauty when you can’t do it!
What seems most unfair about a catheter is, contrary to what I expected, I still fee the need to ‘go’ all the time, even though the urine is constantly draining out of me. I can spend the day watching my bloody urine filling a bag but I don’t get the sensation of relief from having a normal slash. At one point, I tried applying a little pressure, to see if I had any control at all. It hurt like hell so I won’t be trying that again in a hurry!
Another inconvenience of the catheter is the tube gets airlocked. So I have to keep lifting it up to allow the urine to drain. A few times, the flow went the wrong way – a very unpleasant sensation! The catheter I go home with will be different and designed to be mobile. So hopefully I can have a relatively normal life while I have it. I don’t think the other diners would thank me for sorting out my airlocks in the restaurant!
Overall, despite considerable discomfort, my sojourn in The Mater is pretty good. It is a relief to have the first phase of my treatment behind me. The recovery is next and I’m looking forward to it.
My radical prostactomy looms as the countdown transitions from days to hours. I am being admitted to the Mater Hospital at 2pm today, with the surgery to take place about the same time tomorrow.
I still feel very fortunate that I was diagnosed at all. Were it not for my high blood pressure, I would still have cancer anyway. However, I would not have been be aware of it and it would still be growing – and probably spreading – inside my body. This would have had the attendant impact on my chances of survival. So, all things considered, I am a very lucky man indeed, especially given my family history of cancer.
To any man reading this I say: Get Yourself Checked Out! I was only 43 when the bombshell dropped. Since then, I have heard of men as young as 33 being diagnosed with prostate cancer. The perception that you have to be over 50 before you start thinking about the threat of prostate cancer is a mistaken one. You have nothing to lose by going to your GP for a blood test and you have everything to gain. This applies to women too. You won’t get prostate cancer, obviously. But cancer can start in any organ of your body, at any age, and it is utterly indiscriminate.
I was lucky to have a good GP who ticked the PSA box in a routine blood test. But luck is not something to be taken for granted. So get it checked out: you owe it to yourself and to your family, not least your children.
On D-Day, when Prof. FitzPatrick broke the news, my attitude was that I only wanted to live and the side effects of treatment – urinary incontinence and erective dysfunction – would be trivial in comparison. At the time, I said I would “cheerfully” accept them. While still grateful for a second chance, I’m not sure that I can say I’m still “cheerful” about the side effects. Resigned or stoical would be more accurate. Perhaps this is a product of complacency, from learning that my cancer has not apparently spread beyond my prostate gland.
Among the preparations I have had to make for surgery and its aftermath are pelvic floor exercises, to strengthen the muscles pertaining to urinary functions. They mostly involve clenching muscles in the pelvic region and are pretty tedious. I was never one for exercises, as a small fortune in wasted gym membership fees over the years will testify. But the emphasis put on them by the medical team and prostate cancer patients I have spoken to makes me think it is actually about more than just going through the motions.
At my yoga session in the ARC Cancer Support Centre on Monday, one of the guys in particular told me how much yoga and the exercises have helped him to recover. A year after the surgery, he is making good progress, largely thanks to these exercises. So I am now faced with an inconvenient truth: that physical exercise and real effort reap benefits that I will have to work at to realise. Feck!
One of the main benefits of ARC is meeting other patients. I am definitely the ‘baby’ of the class and I almost feel like a pretender as a result. But in conversation with two of the lads, before hitting the mats, one thing that was said, which I hadn’t appreciated before, was that the younger you are, the more aggressive your cancer is likely to be. Oddly enough, this made me feel better (now that I have my favourable MRI and bone scan results under my belt), enhancing my right to be a member of this exclusive club, so to speak.
At the end of the yoga class, the guys were fantastic, wishing me luck with my surgery and giving me phone numbers to ring for moral support. There is a sense of community among cancer patients that is beyond compare. The support from the medical professionals, the Irish Cancer Society and ARC is excellent. But it is your fellow patients – the people who have gone or are going through what you are – that means the most. These are the guys who have stared the prospect of imminent death in the face, pulled through and gone on to live life with renewed vigour.
There is an observation that I am bound to make at this juncture of my experience. In Ireland, we are regularly told about crisis in the health service. While there are undoubtedly issues, I have to say that my experience so far has been entirely a positive one. Having been diagnosed on 16th September, I am having curative surgery six weeks later. That’s not bad, considering a necessary wait between biopsy and MRI/bone scans.
This makes me wonder what I paid VHI for in the years before I quit about six months ago, due to the unsustainable rising cost of private health insurance. I would not have been seen or treated any sooner had I had VHI cover. In some countries I would be turned away if I didn’t have private insurance. So, with all the problems we have in Ireland, including the health service itself, it is reassuring to realise that there actually are some things that do work in spite of all the bad press.
My main point-of-contact with the HSE is my prostate nurse, Mary. She has been absolutely fantastic. Talking to anyone – never mind a woman – about urinary incontinence and erectile dysfunction is difficult. But Mary has a professionalism and sensitivity that makes it easier. In fact, she was way ahead of the curve than I was, foreseeing the emotional issues I’m only beginning to come to terms with now. I was blasé about ED in particular, in the beginning. But Mary, due to her training and experience, was good enough to know that the impact at my relatively tender age would be yet to hit me. The cavalier attitude I have admittedly had up to now is ebbing somewhat. The good news is that my prospects of a full recovery are good, though it will probably take months rather than weeks.
Mary assured me that the plan is to:
- Cure the cancer
- Get me “dry”
- Recover my “erectile function”
I am all for this order of priorities so no problem there. The difficulty I have is that I am only now beginning to realise that the issues of urinary incontinence and ED are going to affect me more than I had at first chosen to believe. It is not that TLC and I have a particularly rampant sex live. It is probably average, at best. But even going from average to zero is disappointing. So there is a body of work ahead of me over the next several months (image of Sylvester Stallone in training as Rocky Balboa, complete with background music!).
The 24 hours between admission and going to surgery will be long. I was given the option of a sedative at my pre-operative assessment yesterday but I declined. I reckon I’m going to have enough pharmaceuticals in my blood as it is and a bit of anxiety won’t kill me. I have plenty of reading material to keep me occupied and if I don’t sleep, it might zonk me out for longer during the day when I will need it more.
I hope to duck out of the hospital in the morning to vote in the presidential election and get back in time for surgery. Hopefully I will be sufficiently recovered on Friday to follow the results online. Election counts are my Cheltenham (sad, I know) so I’d be disappointed if I don’t get to watch the results coming in for my preferred candidate. Thank God for the single transferrable vote – you can’t buy entertainment like that!
Anyway, it’s time to sign off and go under the knife. Wish me luck!