10 seconds that could save your life

This message is for all the guys out there who are afraid to get a DRE (Digital Rectal Exam) as part of their annual physical beginning at age 40. I was one of those guys. My family physician asked me in my annual physical at age 40 if I wanted a DRE and I told him that I would have my urologist do it. I knew that it wouldn't happen because I was not comfortable with a doctor doing the procedure. Since my diagnosis, I have heard this recurring theme from men everywhere. Well obviously I have changed my mind because of my situation. Luckily I was having other symptoms that sent me to the urologist and he performed the DRE as part of the diagnostics. I had no choice to say no. The rest is history. I am now an advocate for the DRE because it was 10 seconds that saved my life. That's right, it only lasted 10 seconds and it was a little uncomfortable, but it's the way they discovered my prostate cancer. (You actually need a biopsy to confirm). The PSA blood test was within normal range and if I had only done the PSA I would still have the cancer in my body today instead of being cured. If I didn't have other issues that caused me to go to the urologist, and followed the American Cancer Society guidelines, which recommend a PSA and DRE at age 50 if you have no prior family history of prostate cancer, I would have given the cancer 9 more years to advance. Finding it at this early age gave me plenty of options rather than waiting. There is some controversy around radical treatment options for prostate cancer, some people say you should wait (watchful waiting) because this type of cancer is slow growing and it could take many years for it to grow. I personally chose the radical prostatectomy (removal) because I could not take the mental anguish of knowing I have cancer in my body. I felt like I didn't want to give the cancer an opportunity to grow and possibly spread outside the prostate. Nobody could guarantee that it wouldn't if I waited. I am also young enough to recover from surgery quicker and have a higher chance of a quicker recovery from the side effects of the surgery. In fact I am seeing a big improvement in my side effects already and it's not quite been 4 weeks since the surgery. I do want to say that every situation is different and you should consult your physician for all your options. In closing I am hoping that all men who read this will understand the importance of getting a physical each year especially starting at age 40 and make sure you include a DRE (Digital Rectal Exam) as part of your physical, it's 10 seconds that could save your life.

Here are the screening guidelines from the American Cancer Society: http://www.cancer.org

The American Cancer Society believes that doctors should offer the PSA blood test and DRE (digital rectal exam) yearly, beginning at age 50 to men who do not have any major medical problems and can be expected to live at least 10 more years. Men at high risk should begin testing at age 45. Men at high risk include African American men and men who have a close relative (father, brother, or son) who had prostate cancer before age 65.
Men at even higher risk (because they have several close relatives with prostate cancer at an early age) could begin testing at age 40. Depending on the results of the first tests, they might not need more testing until age 45.

3 Week Update

Well tomorrow will be 3 weeks since my surgery and I wanted to provide an update on how I am feeling. I have had the catheter out since last Tuesday and yesterday I have finally started to feel normal with limited pain. The tightness from the surgery is 98% gone and I am able to walk about 2 miles comfortably. When the catheter came out I didn't have much control of the incontinence which was expected but a little unnerving for a few days as I was adjusting but I am seeing a slight improvement as each day passes. When I coach people at work I always tell folks that you have to have patience with everything you are doing including your goals and I am now getting to practice what I preach. My goal is to get total control over my incontinence quickly but realize that I need to be patient and do what the doctors tell me and trust in God. Other than that I am trying to get back to a normal life, I have started driving a little and start back to work on Monday. It will be nice to get back to a daily routine.

I also wanted to post a picture of me (less 13lbs post-surgery), my surgeon and ARNP. We took this picture last Tuesday. I want to say that my experience at Shands Hospital at the University of Florida was incredible. Through the entire process I had a great experience from people who cared in every department I came in contact and the process ran like a finally tuned machine. I would recommend Shands Urology to everyone. I especially want to thank my doctor and surgeon, Dr. Sijo J. Parekattil, M.D (pictured on the right below). His bed side manner was incredible and I appreciate all the time he took to explain everything to me in detail and terms I could understand, and really appreciate his skill in surgery (I am healing very well!). I am very impressed with him. I could not have been in better hands. I also wanted to thank the ARNP/Robotics Clinics Coordinator, Lisa Meyer. (pictured on the left below) Her compassion, availability and bed side manner are equally impressive and Peggy and I appreciate everything she has done for us during this entire process. Until next time...

Small Setback and Great News!

I made it back from my Tuesday appointment and had a small setback and also received some great news from the final pathology report. First, I had a cystography done at the radiology department to see if I had any leaks from the surgery. (Meaning where they reconnected the uretha tube after removing the prostate) I basically laid down on a flat table while they put the scanner over my abdomen. Then they used my foli catheter to inject some type of contrast into my bladder. They did this until my bladder filled up while watching the monitor for leaks. Unfortunately they found a small leak during the test. This was a small setback because I was not allowed to have the catheter removed until I was healed. I was so looking forward to having it removed today. The doctor said I had to wear it another week. That was a real downer because of the discomfort it has caused. I was also there to talk with the doctor about my final pathology report. This is the final dissection of the entire prostate after its removed to determine the extent of the cancer along with final staging. I soon forgot about the minor setback as the doctor told us that the final report showed no signs of cancer outside of the prostate which meant that I was considered cancer free, a true survivor. When Peggy and I heard these words we both grinned at each other from ear to ear, but of course Peggy wanted the documented proof before we left the office. We both thanked God and nothing else mattered at this point. All those prayers were answered and I am so thankful. Its so hard to describe how this felt thinking back on all the emotional highs and lows we have been through over the past few months, but I have a renewed outlook on life and appreciate every moment. Its a subtle reminder of how short and precious life truly is.

I wanted to post the actual verbiage from the final pathology report for those of you who might be going through this as a comparative:

Gleason Score: 3+3 = 6
Tumor involves the right posterior lobe
Percent of prostate gland involved by tumor = <5%>
Extraprostatic extension: Absent
Margins: Specimens margins free of tumor
Angiolymphatic invasion: Absent
Seminal vesicle invasion: Absent
Pathologic staging: pT2a NX MX
pT2a: Organ confined, Unilateral, involving one-half of 1 lobe or less

To get more information please go to the following links:

Information on Gleason Score:
http://www.phoenix5.org/glossary/Gleason_Score.html

Information on Stages/Staging of Prostate Cancer:
http://www.phoenix5.org/staging.html

In the coming weeks I will be going to appointments that include removal of the catheter, and then rehab appointments for incontinence and male sexual function. These updates will not be as detailed, but I will post along with my first PSA test at my 3 months appointment. This is important in follow-up monitoring. Thanks again for all the thoughts and prayers over the past few months, it has been uplifting to know how many people care and appreciate each of you!

Thanks!
Darren

The Week After

Okay its been a week since my surgery and it really wasn't what I expected. Time stood still and the toll of the week has begun to show. I've lost 13lbs which is great but would have liked to lose it on my own terms. I am also looking a little pale. I will be back at the beach when this is over working to fix that!. I have been wearing a catheter for the week and hope it will come out in my Tuesday appointment. This is the source of a lot of pain (bladder spasms), and its affecting my sleep along with the tightness in my abdomen and can only lay one way which is uncomfortable. I haven't slept much the entire week and have moved all over the house looking for a comfortable spot to rest. I am taking so many meds that we have kept the local drug store in business for the remainder of the year. I have 1 antibiotic, 1 anti bladder spasm, 2 stool softeners, and 1 pain killer. Its funny the side effects from some meds counter the other meds, its a delicate balance. I have been doing good walking this week. I have made it down the block several times. It's actually funny because I was too tired to change my catheter bag (to a leg bag to hide) so when I was walking, Peggy would come along and put my bag into a beach bag and walk along side of me. Not sure what the neighbors thought about it, but it was a good "funniest home video" moment. Also I wanted to note ALL the great love and support from my family and friends during the past week. During this week we had my work (leadership team) send a ham from Heavenly Ham and gift certificates from a local ice cream shop, my parents also made homemade vegetable soup and one of my neighbors made home made chicken and dumplings. Doesn't seem like I could lose 13 pounds with all this great cooking, but I had to pace myself and was able to eat a little of each. It really helped Peggy not to have to worry about cooking during this week, she has had her hands full with me and Tyler. I also wanted to say how thankful I am for Peggy and Tyler. Peggy has been so great helping me and has not complained at all. Tyler has also been helping me get around and has made things easier. Thanks again for all the prayers, it has really helped me in this difficult time and its very comforting to know that the prayers are coming from all over the country! Even though this was a tough week I really am starting to feel better and look forward to getting back to normal. I have an appointment on Tuesday to get a "Cystogram" which is basically to see if my urethra tube is healing after the surgery to determine if I can have the catheter removed. I will also get the results of my final pathology report which is the final staging of the cancer. I am praying for great results and will let you know...

The Surgery

Well, I can't believe the surgery was last Monday, and today is the following Saturday and my first day with the energy to post something. First let me say how much I appreciate the support and prayers of my family and friends. I am so thankful and overwhelmed about all the support I have received from around the country and especially appreciate all the prayers. It all started Sunday evening when I drank my magnesium citrate at 4:30pm to begin the "clean out" process. Then I received a call around 7pm with a report time for surgery at 6am on Monday (June 30th) to Ambulatory check-in. The drive to the hospital is 45 minutes so we had to leave a few minutes after 5am to park and check-in. I also had to get up even earlier to apply the final clean out medicine so I would have a clean working surface for the doctor ;) It was a tough night sleeping but did manage 4 good hours. The support at the hospital was great. Before I was called back to pre-op I was able to see my wife (she is so awesome!), two sister in-laws, my mom and dad, brother and close family friend. Again, the support was awesome and this helped ease my nerves. I was called back to the pre-op area about 6:15am and put on a great lounging gown and nice shower cap with matching socks and got a bed in room 26 which was one of the famous cloth wall rooms. There were people walking around everywhere and it was loud at times. I was so glad that my wife was with me the entire time in that area and the rest of my family rotated in and out. Listening to all the risk involved with surgery from the anesthesiologist made me a little nervous. It made me think about my 1o year old son and what he would say if I didn't come home. I started to get emotional at this point and they came and gave me something to ease my nerves. It was time to head to the surgery. I remember seeing my wife when I was leaving and also remember talking to my surgeon in the operating room as they were setting up. I asked how his vacation was and that is the last thing I remember until I woke up in post-op. I finally made it to my room around 3pm and had so many visitors waiting, its was very uplifting to see my wife along with family and friends. I was in a little pain, but was in great shape after all the pain meds took effect. I also received some Gator Football Balloons which made me wish football season was here now. The doctor came in at 9:45pm and I was able to sit in a chair while he was there. He had great news about the surgery and said that he was able to spare my nerves and also sent one spot that looked sticky into pathology during the surgery that came back negative. This was all great news. That night in the hospital was pretty rough with people coming in and taking blood, vitals, etc all during the night and the fact that I just had major surgery didn't help either. I felt bad for Peggy as she stayed in the room with me and didn't get any sleep either. A nice PCA tech found her a portable bed around 2am and that helped a little. The next morning the doctor came by at 6am and talked to us about me leaving to go home at 12pm. He did say I would not like him over the next few days and also said something about tough love. That sure peaked my interest and knew I would soon find out. He also asked me to walk around the nurses station at least 4 times before I left that morning. I actually made it 5.5 laps. It was a little tough because of all the tightness, catheter, 2 antibiotics and and IV drip all connected so I looked like a pin cushion walking the halls. For this type of surgery walking, walking and more walking is the key to recovery. They finally discharged me at 3pm and showed us how to take care of the catheter as I have to wear it until the following Tuesday (This is no fun!). I will post my progress during the first week in my next blog. I was very glad to be home...or was I?