Posts Tagged ‘catheter’
Posted in a gainesville georgia urologist, a microscopic vas reversal, a no scalpel vasectomy, a northeast georgia urologist, a overactive bladder interstim, a prostate cancer, a prostate cancer blog, a prostate cancer book, tagged Active surveillance, book on prostate cancer, catheter, early detection, microscopic vas reversal, vasectomy, wife and prostate cancer on May 13, 2012| 1 Comment »
I asked some female nurses who I work with in my amubulatory surgery center what exactly the term “my wife keeps me grounded” means? One lady said that when her husband started talking about all the things he was going to do or get she has to remind him that, ” honey, we need to pay the house payment first don’t you think.”
It reminds me of the story that Lou Holtz, a coach that took Notre Dame to the national championsip, tells about the time he was invited to be an assistant coach at South Carolina and then when he got there with his family the coach that hired him was fired. This in turn meant that his job was gone as well.
As Holtz tells it he then made a list of all the the things that he planned to accomplish in his life. Things like meet the President, skydive, and of course win a national football championship.
“Honey, I have here a list of 100 things I plan to accomplish before I die,” he said proudly to his loving wife.
“Maybe you should add 101…get a job.”
If you are ever drifting off in church or thinking about something good to read get out a bible and turn to Proverbs in the Old Testament. Find the section of wives. Very illuminating and so true today.
“Read about wives in Proverbs like I said….You hear.”
From “The Decision.”
I was totally incontinent for about three months. I initially thought that diapers would manage the problem, but even the most absorbent brand would last only 45 minutes without getting heavy and beginning to sag down between my legs. I went back to work with a full patient load 11 days after my surgery. It quickly became apparent that a diaper alone would not work. Going back and forth to the restroom in between every four or five patients got old very quickly. I then tried the technique of adding an absorbent liner inside the diaper and only changing that, but the liner was cumbersome as well, and still I had to dispose of and replace it several times a morning. I soon found that the only thing that would let me have freedom from all the paraphernalia related to diapers was a condom catheter. We used to joke as urology residents, saying, “I’m going to go empty my leg bag,” instead of saying we were going to go to the restroom. There were residents who would take condom catheters from the urology clinic and put them on at baseball games so they could drink beer without the inconvenience of going to the stadium restroom. I ordered several types to try out (I won’t tell which size I ultimately used) and actually got along quite well with them. The ones I used were like a condom with sticky glue on the inner surface. As you roll it on, it sticks to the skin and forms a water-tight seal; the end of it has a spout that connects to a tube and a bag that attaches to a leg, hence the term “leg bag.” I could wear this under my scrubs and no one knew I had it on. I worked in the office, operated, and even taught youth Sunday school with this set-up undetected. This system malfunctioned and popped open only once. This soaked the pant leg of the scrubs I was wearing, but no one saw it and I was able to correct that quickly with a new pair of scrub bottoms. There was an ever-present fear that it might leak at an inopportune time, but that never happened. I had told very few people who I had had my prostate removed, so hardly anyone knew that I had a “leakage” issue and was wearing a leg bag. I would be speaking to a patient about what they should do for their prostate and answering questions about incontinence, all the while wearing my leg bag. It was an odd time; I elected not to tell patients about my situation. I bet in those three months of wearing protection that I must have treated hundreds of patients with prostate issues. “What would you do if it were you?” they would ask as I could feel my leg bag filling up. The bag holds about a pint, so I could feel it getting heavy and bulging the scrubs at the calf level of my leg. If you let the bag get too full, then it begins to pull down on the tubing, which in turns pulls down on the condom, which pulls down on the… You get the picture. With time, as I am sure it is with most inconveniences that patients endure, all of the issues associated with the condom catheter became second nature, just part of my life.
I would take off the condom before my shower and then jump around to see if the leaking had improved, and each morning for those three months, I was disappointed. Following the shower, I would dry the area to perfection and then carefully roll on my condom catheter and begin the process of hooking everything up. I had a routine that took about 15 minutes. On one particular morning, some of the skin of my “you know what” was very irritated and little blisters were all over the skin, particularly where urine would contact inside the condom. The condom catheter’s glue made taking off the condom a very unpleasant experience, as it would pull at the irritated areas of skin and open the blisters as well. It was very painful to take off the old and miserable to then put on the new. I remember being quite depressed by my situation that morning, more so than usual. As if it were not bad enough to be leaking all the time, now my system for dealing with it was also problematic. The thought of wearing this contraption all day, considering all the movement and discomfort that this entailed, also added to my despondency. The other issue was that if the skin kept getting irritated, I would not be able to use the condom catheter and would have to go back to diapers. I was pondering my plight and was just about “situated” when my wife entered our master bath. I was stooped over in order to connect the rubber straps of the bag to my calf and looked up at her. She looked at me oddly and with what I perceived as a look of concern. I thought that maybe she had detected my frustration and slight depression. I remember being disappointed that my true feelings might have been revealed, as I had been trying to down-play to my family the pathetic “urinary” situation that had become my life. By the way she peered down at me I was sure she was going to ask, “Is everything O.K?” She then said,” John, I think I see a black hair on the tip of your nose.” Somewhat relieved, as I connected the last leg strap, I said, “Thank you dear.”
Risk of infection with prostate biopsy versus the risk of not diagnosing prostate cancer. Which is worse?
Posted in a gainesville georgia urologist, a no scalpel vasectomy, a northeast georgia urologist, a overactive bladder interstim, a prostate cancer, a prostate cancer blog, a prostate cancer book, tagged Active surveillance, book on prostate cancer, catheter, psa, urologic humor, wife and prostate cancer on October 5, 2011| Leave a Comment »
When I was a kid and grocery shopping with my mother the first place I went in the store was to the butcher department.
“May I have some bones for my dog please.” The butcher dutifully disappeared and returned with about five or six bones all wrapped up and gave them to me. Free of charge. I loved it, my dogs loved it and I thought of myself as being smart. It was great getting something useful for nothing and only because I had the courage to ask. Above Penelope is making quite the mess of our outdoor sofa with a bone that I got at the grocery but paid for. She loved it and ate every bit of it and it occupied her for about 30 minutes. I took the picture because she had two feet on the floor and two on the sofa so that she could get “good leverage” on that ole bone, that means it “were a good one.”
Don’t judge me on letting a dog eat a bone on outdoor furniture. The stain you see looks worse that it really is. Really.
A politician who had recently lost an election told a friend that he was disappointed that he had not contributed to his campaign.
The friend said, ” Well…you didn’t ask.”
What was the bible says about asking….hmmmmmmmm?
Well….just don’t do it….now where are you? Can you live with your abnormal PSA or not? Other than tissue (from a biopsy) all other things are “suggestive” of prostate cancer.
What would I tell you having done thousands of biopsies and had one myself? The risk of an infection is about 3% and the patient and doctor should have a heightened sense of awareness about fever. If a temperture is developing then contact or get back to the urologist as soon as possible. What is probably happening is that the urologist gave you Cipro and the infection is not sensitive to it. A culture should be done quickly and a broader spectrum antibiotic given. In my office I have third generation cephlasporins available to give IM that sometimes will avert a hospitalization and used as a daily IM shot untill the culture is back. I admit about 2 people a year from infection after a biopsy and it is a frustrating situation because the bacteria is one that is not sensitive to the usual oral antibiotics and require antibiotics that can only be given by IM or IV administration.
Prostate Biopsy Risk?
In today’s health news: A danger from prostate screening that might catch guys by surprise.
Every year, millions of men have the familiar PSA test that can point to possible prostate cancer. The test is quick and simple – but it can have serious downsides.
In a new study from the Journal of Urology, researchers looked at Medicare records of men ages 65 and older who underwent a prostate biopsy. Doctors may want to do this procedure Ð which involves taking a sample of prostate tissue Ð when a PSA test looks suspicious. They compared more than 17,000 men who had a prostate biopsy with nearly 135,000 similar men who didn’t have one.
Nearly 7 percent of the men in the biopsy group were hospitalized within 30 days, compared to just 2.9 percent of the other men. The men who went to the hospital after their biopsy had complications including bleeding and infection, as well as episodes of other problems like heart failure.
The American Cancer Society doesn’t specifically recommend that men should have the PSA test. It merely suggests that men should get familiar with the possible benefits of testing – and of course the risks – then talk to their doctor about whether testing is the right choice starting at age 45 to 50.
I’m Dr. Cindy Haines of HealthDay TV, with the news that doctors are reading; health news that matters to you.
What’s wrong with the following “press release” about prostate cancer and sexual function-The article in general and the title in particular…Please comment…come on you can do this!
Posted in a gainesville georgia urologist, a no scalpel vasectomy, a northeast georgia urologist, a overactive bladder interstim, a prostate cancer, a prostate cancer blog, a prostate cancer book, a prostate cancer podcast, a urologist gainesville georgia, a urology in gainesville georgia, a vasectomy reversal, tagged catheter, condom catheter, frank zappa, gainesville ga urologist, prostate cancer, sexual function after prostate cancer surgery, urologic humor, wife and prostate cancer on August 26, 2011| 4 Comments »
New Robotic Surgery Technique Maintains Sexual
Function After Prostate Cancer Surgery
The SMART Technique (Samadi Modified Advanced Robotic Technique) Enhances
Surgical Precision and Maintains Sexual Wellbeing After Prostate Cancer
Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics
and Minimally Invasive Surgery at The Mount Sinai Medical Center knows the wide
range of emotions and fears that men with prostate
cancer face. As a robotic
prostatectomy and prostate
cancer treatment expert, Dr. Samadi cares for the total patient, helping
them deal with all aspects of treatment, recovery and cure. Robotic
prostatectomy procedures, performed to remove the prostate gland and surrounding
cancer, can provide excellent cancer cure results, though many men fear the
potential side effects of the surgery. Top on their list of concerns: will they
be able to have and enjoy sex
after prostate cancer treatment?
Dr. Samadi understands this concern. “For most men, sexual function is
equally as important as eliminating prostate cancer. Many of their fears about
sex after surgery are carry-overs from what they know of older open and
laparoscopic prostatectomy techniques. Thanks to robotic
surgery, these fears can be greatly reduced.” Historically, the prostate
gland was removed through invasive surgery during which surgeons had a difficult
time sparing the tiny nerve bundles responsible for erectile and sexual
function. Often, a man’s ability to have sex after surgery was negatively
impacted. With the advent of robotic surgery techniques, experienced surgeons
like Dr. Samadi have an enhanced view of the prostate gland, allowing increased
precision and dexterity. As a result, the risk of damage to the nerves vital to
sexual function is significantly diminished.
When treating his prostate cancer patients, Dr. Samadi employs a
start-to-finish approach, including an individualized evaluation of sexual
function prior to surgery and on-going, post-surgical assessments of options to
aid the return of sexual function. “I consider robotic surgery successful when
the cancer is cured and the patient has full continence and potency. All three
criteria must be met for me to consider the surgery a success.” Dr. Samadi dubs
this whole-patient approach, “Treatment Trifecta.”
Dr. Samadi customizes robotic surgery with his own SMART
(Samadi Modified Advanced Robotic Technique) method. Using the da Vinci
System, the commonly recommended treatment for localized prostate cancer, Dr.
Samadi is able to perform highly precise movements at the surgical site:
cancerous tissue is cleanly removed and critical nerves are spared. By not
opening the surrounding fascia around the prostate and not suturing the dorsal
vein complex, Dr. Samadi has improved the quality of men’s post operative sex
life. Ultimately, this leads to faster recovery and an improved outlook for
regaining sexual function and urinary continence.
“Men want to know they can return to a normal life when this is all over.
They want the cancer gone and they want to move on and enjoy sex the way they
always have,” says Dr. Samadi. While the resumption of sexual potency can take
up to 12 months or more, Dr. Samadi assures patients that this is within the
normal course of recovery. His comprehensive approach to prostate cancer
treatment and sexual wellbeing continues beyond surgery. “It’s not uncommon for
men to experience some ED immediately following prostatectomy procedures, but
this is not an indication of their long-term sexual potency. I continue to work
with patients to achieve the complete results they desire.”
More can be seen from prostate cancer expert, Dr. Samadi, who is also part of
the Fox News Team.
Posted in a gainesville georgia urologist, a no scalpel vasectomy, a northeast georgia urologist, a overactive bladder interstim, a prostate cancer, a prostate cancer blog, a prostate cancer book, a prostate cancer podcast, a urology in gainesville georgia, a vasectomy reversal, tagged catheter, gainesville ga urologist, john c mchugh m.d., prostate cancer, psa, urologic humor, wife and prostate cancer on August 10, 2011| 2 Comments »
In my opinion patients have a better feel for what to expect in terms of impotence and incontinence with surgery than with radiation. You better believe that the urologists out there are telling there patients about the possibility of complications, this is innate to all surgeries. Patients understand that surgery means anesthesia, risk of bleeding, and other complications. They understand that removing the prostate will “mess with stuff down there.” So the below article is a good one , dealing only with surgery and making the point that maybe it’s about be optimistic…I was that way myself.
My beef is with the radiation folks and particularly the Proton folks. I am okay with radiation, I recommend it all the time. These books that tout radiation or Proton beam as if there will be no complications is disingenuous. I believe that if the surgery patient is overly optimistic about the potential or lack of complications, the radiation patient is very overly optimistic. From the get go they feel that because there is no cutting and that the prostate is not removed that the chance of issues is either very small or non-existent.
You will have to just believe me on this. Yes I have seen complications from surgery, but I have seen them from radiation. In regards to radiation the patient is almost always surprised that they have persistent burning to void, worsening erectile function, a change in bowel habits and etc. This is not being critical of a treatment, as I say in my book….”choose your poison.” Another thing patients tend to blame the doctor for surgical problems, but the radiation (not a person) for the radiation problems.
Now you proton advocates…be careful. Yes it is more focused to the prostate with less surrounding tissue damage. However, the prostatic urethra runs right through the middle of the prostate so it will receive radiation just like conventional radiation. So you will not be off the hook for voiding symptoms particularly if you have antecedent obstructive voiding symptoms before treatment. How do I know this possibility? I have a patient who has to catheterize himself to empty his bladder three times a day since having Proton therapy two years ago. He is very happy and feels he was very smart and cutting edge, he had the proton.
Whichever treatment you choose read the informed consent. Radiation patients read very well the potential for complications. They are out there, just like surgery, they do occur and if you doing radiation because you’ll be off the hook for voiding or erectile problems, you’d better think again.
Oh yea. Then there’s cure…why is it the Proton therapy programs only treat the mild to mod grades of prostate cancer? If it is so great why not treat all comers? Hey…I don’t know. I am just asking. You proton advocates please opine.
Men Have Overly Optimistic Expectations About Recovery from Prostate Cancer Surgery, Study Finds
ScienceDaily (Aug. 8, 2011) — Nearly half of men undergoing surgery for prostate cancer expect better recovery from the side effects of the surgery than they actually attain one year after the operation, a University of Michigan Comprehensive Cancer Center study finds.
“This is a belief that does not reflect preoperative counseling which, on the contrary, alerts men to urinary and sexual problems after surgery,” says study author Daniela Wittmann, M.S.W, sexual health coordinator at the U-M prostate cancer survivorship program.
The study, published in the August issue of the Journal of Urology, surveyed 152 men undergoing radical prostatectomy, an operation to remove the prostate. All of the men filled out questionnaires before surgery, after receiving preoperative counseling. The questions asked the men about their expectations of urinary, bowel, hormonal and sexual function a year after the surgery.
The study showed that for the most part, men’s expectations of hormonal and bowel function matched what happened one year after surgery. But, when it came to urinary incontinence only 36 percent of the men’s expectations corresponded to what happened one year post-surgery.
In addition, only 40 percent of men found what they expected for sexual function to be true one year post-surgery.
Also, 46 percent of the men found worse than expected outcomes in urinary incontinence and 44 percent of men found worse than expected outcomes in sexual function one year after surgery.
“When we provide preoperative education, we can only inform men in terms of overall statistics. We can’t predict for the individual,” explains Wittmann. “This may mean that, if in doubt, people tend toward being hopeful and optimistic, perhaps overly optimistic.”
The researchers suggest that it is important to provide men with tools for urinary and sexual recovery after surgery and with support that will lead to the best possible outcome.
Patients who undergo surgery for prostate cancer at U-M participate in the prostate cancer survivorship program. The program includes partners as well. It is designed to provide men with excellent surgical care along with tailored, couples-oriented support both before and after surgery to help ease recovery from the side-effects of surgery.
“Although preoperative education is very important and should be explicit about the general expectations regarding outcomes, we also need to help men and their partners with the recovery process after surgery in order to help them regain their intimate lives,” says Wittmann.
Additional authors are Chang He, M.S.; Michael Coelho, B.S.; Brent Hollenbeck, M.D., M.S.; James E. Montie, M.D.; and David P. Wood Jr., M.D., all from U-M.
Nicely put Tubby Smith…reasonable recommendations about prostate cancer early detection and “male awareness. He said “cancer free” he did not say cured…and that’s a big difference.
Posted in a gainesville georgia urologist, a prostate cancer, a prostate cancer blog, a prostate cancer book, a prostate cancer podcast, a urologist gainesville georgia, a urology in gainesville georgia, tagged Active surveillance, catheter, condom catheter, frank zappa, sexual function after prostate cancer surgery, urologic humor, wife and prostate cancer on May 12, 2011| 1 Comment »
Tubby Smith says he had prostate cancer, now cancer free
6:56 AM, May 12, 2011 |
MINNEAPOLIS — Minnesota coach Tubby Smith says he’s “feeling great” and free of prostate cancer after dealing with the disease for the past year.
The university issued a statement from Smith on Wednesday. The 59-year-old had not previously revealed his condition.
Smith says he had surgery at the Mayo Clinic in Rochester, Minn., on April 21 to contain and remove the cancer. He says a routine physical and subsequent biopsy last spring showed an early stage of prostate cancer.
Smith says he’s thankful to his doctors at the clinic and that he “can’t wait” for next season.
Smith’s fourth year with the Gophers was his most disappointing, stopping his streak of 17 straight 20-win seasons.
Smith released a statement Wednesday:
“Amid speculation I want to make it aware that I did in fact undergo a procedure on April 21 at the Mayo Clinic in Rochester. During my regular physical last spring it was discovered that my prostate-specific antigen (PSA) levels were high. A biopsy was done and it was discovered that I had early stages of prostate cancer. I am happy to say that the cancer was contained and removed and I am now cancer free and feeling great.
“I want to thank Dr. Gettman and Dr. Litin at the Mayo Clinic for everything they have done for me. I am a proponent of regular prostate examines and hope that men, especially African-American men, continue to have regular checkups. Again, I am feeling great and can’t wait for the upcoming season.”