It started one September morning when I got out of bed and peed blood. That wasn’t a good sign, ao I called my primary care physician. She instructed me to go directly to the local hospital.
At the hospital, a urologist performed an ultrasound of my bladder and admitted me for a cystoscopy. This involved inserting a catheter into my penis so he could inspect my bladder by feeding a cystoscope through the catheter up into my bladder by way of my urethra. The cystoscope had a lens that let him inspect my bladder for signs of cancer. He was then able to pass a special tool through the cystoscope to remove several polyps for analysis. Fortunately, I was sedated throughout this procedure.
I awoke in a hospital bed. The first thing I did was push down the sheet covering my lower body and discovered the catheter was still in place. When I saw the size of the catheter and thought about the urologist forcing it into my penis, I was very glad to have been sedated.
Any modesty I had evaporated with this procedure. I had never before had so many people concerned with my manhood. For the next two days, I had nurses checking every few hours for any sign of infection.
On the third morning, two nurses came into my room to remove the catheter. They explained what they were going to do and pulled down the top sheet. One nurse took hold of my penis. The other said to take a deep breath and then exhale when she told me to. When I exhaled, she pulled out the catheter. The pain was brief but intense.
Having two attractive young women handling my penis would be a sublime fantasy In a different situation.
The results of the procedure were not good. My bladder was riddled with cancer.
The urologist explained that I had two choices. It was either a slow, lingering death from cancer or have this very scary operation. As if I really had a choice.
He referred me to Dartmouth Hitchcock Medical Center, the largest hospital in northern New England, for the surgery. There, I met my new urology team. The chief urologist was a large man with a Nordic accent who was all business. The rest of the team were handsome young interns wearing matching dark green scrubs and colorful scrub caps. After more ultrasounds, the team performed another cystoscopy that confirmed the diagnosis of the first one. They scheduled me for surgery.
The chief urologist explained he would be removing my bladder and my prostate. He said he would take a section out of my small intestine and then reconnect it. The section would be used to create a new bladder. Because this faux bladder didn’t have the necessary muscles to function like a bladder, it could not control the flow of urine. It would be surgically attached to an opening in my abdomen called a stoma, where a plastic pouch could collect the urine. He said it was a complex surgical procedure that would take 4 to 4 1/2 hours, but he had successfully performed many of them before.
He didn’t mention that I would lose all sexual function.
In less than three weeks. My life had dramatically changed.
The morning of surgery, I arrived at the hospital at 6:00 am. I was taken to a small pre-op room, where a nurse instructed me to take off all my clothes, put on a hospital gown and and lie on a gurney. An anesthesiologist came into the room and explained he was going to start anesthesia. He inserted an IV line into my arm and injected something through the line. I began to feel sleepy. As a nurse wheeled me to the surgical suite, he asked me how I was feeling. I replied that I felt like I was being wheeled on a gurney to surgery and then fell asleep.
The procedure went as planned. I awoke the next morning in my hospital room with no pain, thanks to oxycodone. The nurses encouraged me to get up and walk around the unit. I liked walking, but I soon grew bored walking around the big nurse’s station. So I decided to leave the unit and walk around the hospital.
DHMC is a large hospital. From the door to my unit, I could walk by the life-size moose sculpture down the North Mall to the main entrance. There, I could turn left down a long hallway to the East Mall, which runs parallel to the North Mall, then turn left down to the end of the East Mall, where a long corridor led to the nuclear imaging center. Then another left turn down a long corridor past the wonderful Sol Levenson mural back to the moose sculpture. I estimated the whole trip had to be the better part of a mile.
What I didn’t know was that I wasn’t supposed to leave the unit unless accompanied by a nurse. Someone turned me in during my first midnight excursion, and one of my unit nurses was sent to capture me. I was eventually able to convince the urology team doctors that I had no risk of falling and was allowed to tour the hospital alone.
At least four members of the team came together in their scrubs and scrub caps to visit me every morning around 11:00 a.m. They said they would let “the boss” know how I was doing. “The boss” visited me every two days to personally confirm that everything was properly healing.
Specialty nurses showed me how to change my urostomy pouch. The pouch has three pieces: the gasket that makes a water-tight seal around my stoma, the skin barrier that adheres to the gasket and my abdomen, and the pouch that snaps onto the barrier. It’s a simple but reliable device that must be emptied every 2-3 hours and changed every 3-4 days.
Wearing and changing the pouch was humiliating and annoying at first, but I soon grew accustomed to it – particularly when considering the other choice.
I was in the hospital for nine days before I was released. “The boss” said I should continue walking and could gradually resume my daily exercises.
After being home for a day, I was a little annoyed and depressed at having to do everything for myself again. No button to call a nurse if I wanted something. My lovely wife was a wonderful one-woman support group, but had no intention of being my nursemaid.
As the weeks crawled by, I regained my strength. I was shocked by how much muscle tone I lost by being in bed just nine days. I also lost 20 pounds.
I looked up online how much an adult human bladder weighs and learned it can weigh up to eleven pounds when full. An adult male prostate weighs less than one-half pound. Throw in a few lymph nodes, and it’s still under 12 pounds.
Am I glad I made this choice? Absolutely! Do I like having to wear this pouch for the rest of my life? No!
My cancer is gone for now, but I will continue to have regular follow-up screenings. Whatever the results of those screenings are, I’m grateful to have additional time with my wife, my children, my two granddaughters, and my four great-grandchildren. And additional time to cross things off my to-do list.
A positive outcome of this whole experience is that I no longer have to worry about erectile dysfunction.
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