For me, prostate cancer brought many fears and worries to the fore, besides the
possible consequences of cancer and my mortality. One of these was how I would
gain control of the bladder and avoid incontinence, one of the potential side
effects of my choice of treatment - surgery.
During surgery, a catheter
is inserted and is left in place for about three weeks while the remaining sphincter
learns to cope with it's increased workload. So my first objective was to come
through the operation without too much pain and to survive the three weeks of
the catheter. Survive might sound strong, but the thought of having a plastic
tube stuck into my penis was almost as frightening as the post-catheter fear of
not having control of my bladder and being swathed in diapers for the rest of
my life
Early on the 26th of February 2001, I checked into the urology
ward. The first thing I noticed were the bags that most of the patients were carrying
around with them. These bags were attached to their penises via the catheters.
Would I be so casual and at ease with my bag? I noted that there did not seem
to be a 'standard' way of wearing this accessory. Some carried the bags in their
hands, others had them hooked onto the pocket of those awful hospital gowns. Many
of them were full of a reddish liquid while others were a piss-yellow. I now realize
that I had resigned myself to what ever awaited me and would make the best of
the situation. I knew that within 24 hours, I might be joining the "club".
Let me explain: one of the fears of cancer in the prostate is that the cancer
has escaped from the confines of the prostate and spread to the surrounding areas.
If this is found to be the case, the surgeon will abort the procedure and would
not remove the prostate nor insert a catheter. In one of the books I had read,
the author tells how, on coming around after surgery, he immediately felt to confirm
that the catheter was in place and was ecstatic to find the tube protruding from
his penis. It confirmed that the cancer had been confined to the prostate. I too
found myself reaching for my penis, on coming around from my surgery, for that
comforting confirmation that the cancer was out of my body. The catheter was in
place and a new phase of my life had begun.
That first night after surgery
I dreamt that I was drowning in piss. The following morning I woke up to find
that I was lying in a bloody liquid. During the night, the bag had worked loose
from the catheter and I was lying in the resultant spill of bloody urine. That
was my first disillusionment about my 'comforting attachment'. However, there
is always an up side to everything. Two young, good-looking student nurses were
sent to bed-bath me: not that I could appreciate their touch! But I enjoyed the
experience of being sponged and pampered.
The handling of the bag soon
became a subconscious action. For example, when lying on the bed, I hung the bag
on the bed railings and of course had to remember when getting out of the bed
to attach the bag to my gown. I suffered no pain after the operation and was walking
around the following day. As the bag filled up, it became heavy and I soon learned
where spare bags were kept so that I would not be carrying the extra weight. The
nurses changed bags three times a day, but I did it at least six times daily.
The patient's progress was judged by the color of the urine in the bag. In other
words, discharge from the hospital could only be considered when blood no longer
showed in the urine. What a relief I felt on the fourth day when I woke up to
a clear bag. However, after exercising, there was the reddish hue in the bag again
and I realized that exercise at this stage was out of the question. More than
anything I wanted to go home.
On the morning of the sixth day, after ward
rounds, the chief surgeon said I could go home. I phoned my wife, Myrna, to buy
a leg bag to attach to the catheter and to come and pick me up. Now I was faced
with another problem. I was not going to walk around the streets with the piss
bag in hand or hooked to my trousers. Myrna was picking me and my catheter up
at the main entrance to the hospital (there is no parking near the hospital) with
the leg bag. How to manage? I solved the problem by scrounging a large safety
pin from one of the nurses and pinned the bag to the inside of my trousers. At
home I would attach the leg bag.
The leg bag has straps for attachment
to the leg, and a tube, which you plug into the protruding appendage dangling
from your penis. At the bottom of the bag is a tap whereby you can drain the urine
when it fills up. The nurses suggested that I use a standard bag whenever I lay
down.
The catheter created an unexpected problem the first time Myrna and
I lay down together. For years before going to sleep we would cuddle for a few
minutes, which meant turning inwards. The bag was lying on the floor at my side
of the bed and the connecting tube made this move very uncomfortable for me. While
in hospital, I had not encountered this problem as the bag was hooked on to the
bed, thus allowing more freedom of movement. Another obstacle to overcome and
a change of habit.
I soon settled down to a routine of changing or emptying
the bags. When going to lie down, I would walk to the bedroom dragging the bag
on the floor behind me. My daughter had been in India and had photographed a guru
with a rock suspended from his erect penis and I pictured myself building up the
muscles to do similar feats. We went to a party and I found it amusing when swinging
my leg, to watch the expression on the faces of people who heard the sloshing
(from the urine bag) - which of course was covered by trousers-and not knowing
where the sound was coming from!
After three weeks of "wearing" the catheter,
it was time to take it out. Then I had frightening thoughts about the extent of
control I would have of my bladder. Would I have any control at all? My fears
of incontinence after the operation made me determined to create as much control
as possible. For two months prior to the operation I had being doing exercises
to strengthen the sphincter muscles. On my discharge from the hospital, I was
told to bring adult diapers on the day that I would have my catheter removed,
as there could be a steady uncontrollable flow of urine. After the relatively
easy time I had had up to now, I felt confident that I would have some sort of
control, so decided to find the thickest sanitary pads available and took them
with me on my return to the hospital to have the catheter removed. The nurse who
removed the catheter raised her eyebrows and mumbled something about me being
an optimist, when she saw me putting the pad in place. Well, optimist or not,
after three days I was down to using only two pads a day. Furthermore, after a
week, I was using one a day. After two weeks, I was using one ultra thin panty
liner a day.
I cannot say that I was sad or depressed to part with my catheter.
Six weeks after the operation; I had control of my bladder. The next hurdle was:
would my potency return or would I use Viagra or other potency aids?
