The first hiccup of the week was when my first radiation appointment, scheduled for Tuesday, got cancelled when the machine broke down. That meant my first radiation treatment wasn't until Wednesday, just a couple hours before surgery for the polyp.
The surgery itself went well enough. I was put under general anesthesia, and then all sorts of equipment was shoved into my penis, up the urethra, and into the bladder to remove two growths, followed by a catheter to fill the bladder with a chemotherapy solution and hold it there for 30 minutes while I was in recovery. The main points here are that there is anesthesia, as well as incisions inside the bladder and some amount of wear and tear to the urethra to recover from.
There were two decisions made after surgery that in hindsight turned out to be poor decisions. The first was the decision to remove the catheter used to fill and then drain the chemotherapy solution from my bladder. The second was to send me home after only passing a small amount of bloody urine, despite my protestations that it seemed as if something was preventing me evacuating normally. Apparently this is a common post-surgical complaint, and most of the time it turns out to be a false sensation.
In my case, it was a real sensation. After a 90 minute ride home including a stop at the drug store to fill some post-op prescriptions, I was feeling every pothole in the last several miles. But I still wasn't able to pass more than a few drops at a time. A call back to the hospital netted the suggestion to have a cup of tea and use a heating pad near the bladder to trigger the urination reflex, and if that didn't work by midnight go to a nearby ER. Of course, the tea did little more than provide more fluid to fill the bladder and up the urgency.
It became exceptionally painful, even though I was on a prescription pain reliever. The bladder hurt because it was distended and had just had growths removed. What did pass caused extreme pain in the irritated urethra. By the time midnight rolled around, I was screaming in pain with each unsuccessful attempt. There was a brief flash of hope when more than a few drops came out, but that effort couldn't be repeated.
So off to the ER at half past midnight, and I walked in with my hand cradling my much abused and hurting penis and lower abdomen. At this point all thoughts of being a strong person had left me. I simply didn't want "urinary retention" as my cause of death.
So to make a long painful story a tad bit shorter, they eventually got a catheter put into me on the second attempt. The first attempt was excruciating. The second one with a different catheter even more so. I was exhausted and in agony and had given up all self respect and freely screamed in pain throughout this procedure. It is easily the most pain I have felt in my entire life.
Happily, after about a quart of fluid was drained the pain had largely gone away and I was sent home with a catheter into my bladder and a baggie strapped to my leg. Unfortunately that catheter clogged on Friday morning. At least that was during normal business hours so off to the urologist for an urgent appointment.
At the urologist, after another several hours with a very uncomfortably full bladder, the plan was to estimate the amount of urine in my bladder using an ultrasound like machine, then remove the catheter and see how much I could void naturally. Of course, with the luck I'm having this week the batteries in the machine died so the nurse had to go fetch a fresh set.
The estimate was 650 cc, and I naturally passed maybe 50 of that. Shit. Hello catheter number three. The good news is that my pain levels were much lower, so I was able to deal with it using deep breaths and trying to relax, and no screaming was involved. The urologist didn't have great things to say about the configuration the ER had left me with, and instead of a bag he put a valve on the end which makes life with the catheter much simpler.
What's troubling is the urologist doesn't know why I'm not able to piss naturally. It could be inflammation and swelling in the bladder, as the growths were near the bottom where it necks down into the urethra. It could also be nerve damage due to the metastasis in my spine. It's hard to tell since the surgery and the first radiation treatment were so close together. We'll re-evaluate the situation next week after finishing the radiation treatments, and if needed there are less extreme options than a full catheter.
While this was going on I had three radiation treatments. In addition, the third front of this cancer war is the hormone therapy injection I was given a little over two weeks ago, which should be starting to take effect now. All of these things can cause side effects such as fatigue and nausea, so it's no surprise I've spent most of the last couple days laying around on the couch or in bed feeling sick to my stomach. That is, when I'm not in a complete panic about my ability to urinate.
Which brings us to today. Much of the past week has gone by in a haze of stress or napping (sometimes aided by a prescription opioid). Today I've recovered enough to occasionally get off the couch for 30 to 60 minutes at a time, including writing this post. The emotions are starting to hit me.
Last Tuesday, before this latest skirmish in the cancer war, I was able to go on a 2 mile walk and haul a load of trash and recyclables to the town dump. I could go out to a restaurant for lunch. I could travel to Vermont and at least enjoy the scenery and maybe even an easy stroll by the pond.
Today, I've got a catheter hanging out of my wanker that tends to chafe and irritate me with any significant movement. My back pain seems to be flaring up as a result of the radiation treatments. I sleep for about 12 hours a day, lay around most of the other 12, have little interest in food, and generally worry about whether the current catheter will continue to function.
At some level, this is all perfectly expected after what I've been through in the past week. But on the other hand, I still have two more radiation treatments, then a short break, and then chemo begins. The though that I'll be stuck in this loop of sleeping, pain, and nausea for weeks scares me deeply.
As the saying goes "If you're going through hell, keep going", and I'm clinging desperately to the hope that eventually I will emerge on the other side. It's just that after a week where every light at the end of the tunnel seems to be an oncoming train, it's very difficult.
As always, the silver lining is the love and support I have received. Please continue sending the thoughts, prayers, hugs, care packages, well wishes, whatever you can do. It seems I'll need them in increasing amounts in the coming weeks.
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