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.