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IS THERE LOVE AFTER PROSTATE SURGERY?

Senior African American couple at home hugging and smiling

Prostate surgery is a treatment option that strikes fear in the hearts of some men with prostate cancer. I know. I was one of them. Possible surgery outcomes includes: urinary incontinence  and erectile dysfunction. I had one main question. Is there love after prostate surgery?

After I received a few moderate increases in my PSA levels, my general practitioner suggested I visit a urologist.  That made me nervous. I was reluctant to share this information with my wife. I took his recommendation and made an appointment with urologist Dr. Christine  Cumarasamy MD. 

FIRST MEETING WITH Dr. C

In Dr. C’s office, she reviewed my PSA lab results. She asked had anyone in my family ever had prostate cancer?  I hadn’t been honest with my general practitioner and I wasn’t ready to share my secret with her either. “No.” I answered.  I felt guilty lying.  Dr. C appeared to be a very caring physician. But on this day, I was not in a trusting frame of mind. I was hoping she would simply continue to monitor my PSA levels. Hope quickly faded. “To be on the safe side, I will order a prostate biopsy,” she said. That was not what I wanted to hear.

SECOND MEETING WITH Dr. C

Following the prostate biopsy, I went back to Dr. C for the results. I knew that according to statistics one in six Black men will develop prostate cancer in their lifetime compared to one in eight men overall. But why would I have needed to worry? I exercised every day and was  in good physical health. Also, I had no symptoms. Nevertheless, I entered her office with both my fingers and toes crossed. My optimism was short lived. She looked up from her lap-top computer. “You have prostate cancer. You have a Gleason 7. Your cancer was contained. It had not spread” That was too much information to process. I had no idea what the Gleason score 7 meant. However the expression on her face told me  it was not good. An alarm went off in my head. I felt my heart beating faster. I tried to calm down while she explained the results. This was followed by a discussion of treatment options: radiation or robotic prostatectomy. She said after the surgery I would have to wear a catheter for 10 days. As she spoke, I had a vivid recollection of my brother at home after prostate surgery. I helped him get into the shower while he held his catheter. He was in pain. I didn’t know why. But what I did know was that I never wanted to end up like that. I had to force myself to get back to my reality. I wanted to jump up and run out of her office.  But how would I explain my action to my wife? I calmed down long enough to say I had to think about this. Dr. C did not pressure me for a decision right away. She was probably wondering why I would hesitate to jump at a chance to save my life. What she didn’t know, I was more concern with saving my manhood.  I needed help making this decision.

I had too much to lose. After two failed marriages, I had finally found the woman I loved. I wouldn’t allow anything to get in the way of our continued fun and love making. It had been 30 years of bliss.

DISCOVERY

I scoured the internet for everything written on this topic. But nothing I read addressed my concern. Then one day at the local library, I came across a book that spoke to me. The book titled TAKE THE RISK   was written by Dr. Ben Carson an African American neurosurgeon. The book is about learning to identify, choose and live with acceptable risks. Although I had no symptoms, I was able to identify with Dr. Carson’s story. He was having a difficult time getting through a 10 hour surgery without having to stop and go to the bathroom. His urologist told him he was probably experiencing prostatitis, an inflammation of the prostate. He gave Dr. Carson an antibiotic. The symptoms persisted. Next, his urologist guessed he had prostatic hyperplasia, an enlargement of the prostate. So he ordered the drug Flomax. Nothing changed.  Now Dr, Carson was getting worried. His urologist suggested getting a PSA test. It came back slightly elevated. Next a prostate biopsy was performed. His urologist told him the chances of prostate cancer was only 18%. So Dr. Carson relaxed and waited for the results. One day following the biopsy, he got the call while in the operating room. The biopsy indicated that he not only had prostate cancer but a very aggressive form.  He began examining treatment options. Before deciding on prostate surgery, Dr. Carson evaluated the risks of nerve damage that could result in urinary incontinence and sexual dysfunction. Prostate surgery had a higher rate of success than traditional radiation treatment. If he had the surgery, that meant the permanent removal of the cancer. As long as the cancer was contained, the odds of a complete cure and normal life expectancy was good.  He pondered the worst possibility with surgery. That was the risk of nerve damage that could leave him incontinent or impotent. So if the cancer was contained and the tumor removed he should be cured of the cancer and have a normal life expectancy.

His mind was on his wife and children that he would be leaving behind. He reflected on all the things in life he had taken for granted. He was going to start enjoying more of God’s gifts. Dr. Carson had a robotic prostatectomy. Fortunately, his doctor was able to remove the tumor and spare the nerves. The following PSA test dropped to undetectable which was the goal. Dr. Carson went back to work in less than a month cancer free. Although he realized the chance of a recurrency was a possibility, he anticipated a long and healthy life.  

There was a section in his book where he described his wife’s reaction when he revealed his diagnosis. She had a tough time processing a life without her husband. At night she would cry. Her crying would wake up her husband in the middle of the night.  It was so heartbreaking for him to witness. When I read this, it opened my eyes to a fact I had’nt considered. More important than sex was how unhappy my wife would be without the man she loved. I had given too much attention to the physical side of our relationship. Although important, it was not everything. For the first time, it was clear to me that my hesitancy regarding prostate surgery was based on a misplaced priority- the loss of lovemaking not love. My thinking had been shallow.  My wife was a strong woman. But my death would cause her unbearable pain. Why would I risk losing my life just to save my manhood? That made no sense. So I made the decision to have the prostate surgery. I was in full agreement with Dr. Ben Carson. Some risks are worth taking.

Dr. Carson wrote a message in his book that spoke directly to me.

Hey guys let me share what is evidently a little known medical fact- there is a 100 percent chance of impotency if you are dead.

POST SURGERY

The surgery was a success!!! My wife and I were blessed. Dr. C performed a flawless robotic prostatectomy.  Since the operation, I have only encountered a few instances of erection delay. For that, Dr. C gave to me a few tablet samples of a form of Viagra.  Fortunately, it was not long before I didn’t need any assistance. I could finally report. THERE IS LOVE AFTER PROSTATE SURGERY!

I am also blessed to have had no urinary incontinence issues.  My PSA tests shows undetectable. It will be tested regularly to spot any signs of a recurrence.

 IN CONCLUSION:

I would advise any man with prostate cancer to seriously consider having a prostatectomy. I completely understand why you may be hesitant accepting this treatment option. There are risks involved. But there are some risks worth taking. In the long run, this surgery has a better success rate than the other treatment options. So, find a skilled urologist with years of robotic surgery experience. You want someone who:

  • You can trust.
  • Will answer all your questions.
  • Will tell you exactly what to expect post – surgery.
  • Will follow your progress for years after surgery.

Before you make the decision not to have surgery, consider the impact on the people who love you.

I will admit, although I was in my late sixties, the realization that I could never have a biological off-spring was unsettling.  But in hindsight, I have absolutely no regrets.

ARE YOU WALKING INTO DARKNESS?

Glaucoma is not a disease many people know much about. It is a disease with practically no symptoms. If left untreated it could lead to blindness. African Americans and Hispanics are at increased risk of developing glaucoma. It is estimated that nearly 1.5 million Americans are walking around undiagnosed.
I have been getting an annual eye examination from the same ophthalmologist for years. I have always worn prescription glasses for poor visual acuity. So, other than occasional periods of blurred vision, that has been the extent of my vision issues. I simply attributed the blurred vision to not blinking enough when working on the computer at work. Then one day while having a casual conversation with a co-worker, I found out that she had also, in the past, gone to my eye doctor. But for some reason, she decided to try someone new. She was now seeing Dr. Dina Weintraub, a glaucoma specialist. She suggested I give her doctor a try. I told her thanks but no thanks. Well, I thought that was the end of it. But every time I would see her, she asked had I given her doctor a try? I really had no reason to believe another doctor would find anything else wrong with my eyes. But to stop her from asking me that question, I made an appointment. I am so lucky I did.
Dr. Weintraub is one of the most caring, soft-spoken and knowledgeable doctors I have ever met.
After an extensive examination, she gave me her diagnosis. “You have open-angle glaucoma.” But before I was able to process that revelation, she went on to say I had extensive optic nerve damage to both eyes. And the damage was irreversible. The pressure in the left eye was 52 and the right eye was 46. Normal intra-ocular pressure is 0-21. If you did not have so much damage already, we could gradually bring down your pressures. Some people may be okay even with pressures this high. But not you. She said we had to immediately get my eye pressure down before the optic nerve is completely destroyed. At 62 years old to find out I could go blind was shocking. I told myself this could not be happening. I was in total denial. How could that be? This has to be a mistake. I insisted she does the tests over. I was certain my eye doctor who had given me an annual exam for years would have detected a problem with my eyes before now. Dr. Weintraub tried to make sense of it. Maybe your pressures were not elevated on the day you went for your annual check-up. And maybe the doctor never examined your optic nerves.
When I calmed down, she carefully explained to me what glaucoma is. She said that eye pressure is a major risk factor for optic nerve damage. In the front of the eye is a space called the anterior- chamber. A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues. The fluid leaves the chamber at the open angle where the cornea and iris meet. When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

In open-angle glaucoma, even though the drainage angle is “open”, the fluid passes too slowly through the meshwork drain. Since the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve. When the optic nerve is damaged by increased pressure, open-angle glaucoma and vision loss—may result. You would first start losing your peripheral vision. That’s why controlling the pressure inside the eye is important. So I was handed four eye drops prescriptions and a tablet prescription for the drug Diamox. This drug has a side effect of weight loss, which was very profound in my case. The goal was to get the pressure down to a very low level and to maintain that low pressure.
After using the different eye drops and taking the Diamox for weeks, my pressures were up and down like a roller coaster. When I started using the drops, getting the drops accurately into my eyes and not running down my cheeks was a challenge. When I would visit the doctor and be told the pressures were still high, I attributed it to me not doing a proper job of getting the drops into my eyes. I then bought a gadget that was to improve my accuracy. It was much easier to feel the refrigerated eye drops when the cold drop hit my eyeball. After instilling the drops, I was told to apply pressure to the corners of the eye along the bridge of the nose, hold for a few seconds. This prevented any drug from escaping the eye out through the nasal lacrimal duct.
Unfortunately, despite my best efforts, the pressures wouldn’t stay low. Dr. Weintraub was not happy. “I think it’s time we consider surgery”, she said. This was not what I wanted to hear. Just the mention of the word surgery, caused my claustrophobia to kick in. I could not see myself buckled down on an operating room table, unable to move. She saw I was uncomfortable with her suggestion.
So she tried to get me to focus on the benefits of surgery, and the importance of vision. Without surgery, I would have to continue using the eye drops. But more importantly, I could still lose my sight. So I settled down and focused on what I had to lose without the surgery. Never to be able to see my beautiful wife’s face was just one factor that weighed heavily on my decision. I am an avid reader. I read at least ten books, at a time, on my kindle fire. I also look forward to every spring working in my garden. I eagerly await the appearance of my tulips and other beautiful flowers that decorate my garden. Plus not to be able to continue to write my blog and to draw would leave too deep of a void in my life.
She recommended Dr. James McDermott, a surgeon she trusts. When her father needed surgery, she sent him to Dr. McDermott. Despite her confidence, I was still nervous. I wanted the assurance everything was going to work out.
After meeting and talking with Dr. McDermott, I felt confident I would be in good hands. He told me I would be a candidate for an operation called a Trabeculectomy. He said it was a procedure that creates a new drainage channel for the aqueous humor to leave the eye. During the procedure, a small flap is made in the sclera (the outer white coating of your eye). A filtration bleb, or reservoir, is created under the conjunctiva – the thin, filmy membrane that covers the white part of your eye. Once created, the bled looks like a bump or blister on the white part of the eye above the iris, but the upper eyelid usually covers it. The aqueous humor can now drain through the flap made in the sclera and collect in the bleb, where the fluid will be absorbed into blood vessels around the eye. He had successfully performed this operation numerous times. He also instructed residents on the proper surgical techniques.
The surgery on the left eye had to be done first because it had the most optic nerve damage. This was performed at New York Eye and Ear Infirmary of Mount Sinai on October 25, 2011. The surgery on the right eye was performed on November 22, 2011.
Although Dr. McDermott told me the operation had gone well, I needed to see proof through my own eyes. After each operation, the waiting was nerve wrecking. All day every day, I wondered whether or not my vision would return to normal?
I couldn’t see clearly out of the un-bandaged eye. I couldn’t read. I could barely watch television. Periodically, my claustrophobia would kick in. I needed an escape. I was desperate to get back to work simply for the distraction. But instead, I had to remain home and ponder my fate. I was going stir crazy. I would go for long walks in the sunshine to renew my spirits. Eventually, my vision did return to normal. The pressures in my eyes remained low. But, as a result of the surgery, cataracts developed in both eyes. So far they have not posed a big problem. Removing cataracts could possibly reverse the good results of the surgery. So, I will refrain from having cataracts removed for as long as possible.
I am so grateful to Dr. Dina Weintraub for diagnosing my glaucoma condition and to Dr. James McDermott for performing the surgery.
Now that I been through this experience, I would like to share with you a few tips that
may help you avoid a similar situation
TIPS:
• Get an eye exam at least twice a year.
• Ask your eye doctor to check your eye pressures on each visit
• Keep a record of eye pressures after each visit.
• If you are older than 50yrs, periodically request a visual field and optic nerve exam.
• If on eye drop medication, keep a daily log of date and time you put in the drops. Make the entry after instilling the drops, not before. Sometimes you may be interrupted by a phone call or conversation and not recall if the drops were put in. You don’t want to either under-medicate nor over-medicate.
• For more information visit https://www.nei.nih.gov/health/glaucoma/glaucoma_facts

Remember: glaucoma does not come with warning signs.