Finally got it done!

The final frontier. Deciding when, if and how.
VietNamVet
Posts: 10
Joined: Sat Sep 06, 2014 12:14 pm

Finally got it done!

Postby VietNamVet » Wed Sep 17, 2014 5:16 pm

It took a few days to get authorized for the board, but I'm determined to record my progress here, as reading your previous posts was a great help for me.

I was implanted with a Coloplast Titan (20cm + 2cm extension) on 4 Sep 2014 at the VA hospital in Dallas. Part of the reason for that was cost, part was that I got a much better feeling talking with the Urology residents there than a "good" surgeon in Fort Worth a couple years ago. VA hospitals have been getting abad rap recently, including Dallas. I can add to the bad rap: the administrative folks don't seem to take their jobs very seriously in Dallas - I once waited over an hour for someone to show up at the general services desk... (The Fort Worth Clinic, however, does not have such problems. My guess is the FTW is staffed mostly by vets, and Dallas administration is not.)

Back to the subject.

It took about 6 months to get everything set. Met with my primary care at the beginning of the year and scheduled an appointment with the Uro Clinic in May (earliest possible!). Unfortunately, they also had to follow up on a possible prostate nodule (turned out to be nothing), so the ED appointment, which should have been the same one, was lost from the system (software design error as near as I can tell). After 3 weeks, no appointment scheduled, so I tried to call - typical "telephone hell" that ended with a phone ringing over 50 times and no answer, no answering machine. I drove back over to the Dallas Uro Clinic the next day and got it set up in person for 9 Jul. (Note to vets: it can sometimes be much easier to get things done when you're standing right there - hard to "lose the request." Be polite, but firm, and have whatever paperwork and records you need in hand. The Big Blue Button is a wonderful thing.)

The initial appointment with the doc was uneventful. Took additional information for the history and did a physical exam of the equipment. The doc also pointed out that I was a "bit" shorter than I should be because of my weight (about 80 lbs over). Note to self: keep losing weight! That appointment took about 30 minutes. Note to those considering this surgery: consider taking you wife/SO to these appointments. I also had to meet with Dallas Cardiology and Anesthesiology to get medical clearance (I have 3 stents) for the surgery, as well as obtaining a written release to get off of Plavix a week ahead of time from my own cardiologist. That last part took a couple of weeks, as I thought the VA was requesting it based on what I was told, but it turned out that I had to request it. Once the paperwork was done, I was scheduled for 4 Sep, with yet another trip to Dallas for bloodwork,, chest X-rays, another meeting with Anesthesiology (measured my throat, took more history) and Day Surgery Nursing. Three days ahead of the surgery I started showering using a disinfectant soap they gave me.

4 Sep.

I arrived at 6AM, went to prep after about 15 minutes, and was in surgery fairly quickly. The IV took a number of sticks in both arms, but they finally got it in. I'm told I have thick skin, which makes it hard to find the veins. Who knows. The vampires (phlebotomists) never seem to have a problem. In the prep area, I met with the the surgeon and two additional residents and then actual Anesthesiologist who made some final checks. I'm not sure when I was out, but it was while I was still talking. I think they just like to do that to be sure you're really out?

In recovery, they woke me up (of course), gave me the results, and put a jock strap on me. The first thing I discovered was that the Foley catheter would stay in place until the next day. I talked to the surgeon again, who told me the surgery was "textbook" and that he thought I would be happy with the results. The numbers sounded (still do) good to me. One of my concerns was how much saline they would use. The Titan reservoir is 125cc, and he put 60cc in the implant itself for partial inflation, and another 75 in the reservoir. That should be sufficient! Total blood loss was about 30cc.

Pain was minimal, being about a 2. They had already started IV antibiotics, including Rimapfin and something else. By 2 PM, I did have significant pain (8) and some nausea (probably the antibiotics). Dilaudin reduced the pain to a 2, which is amazing, because most things, including morphine, have little or no effect on me. I did eat lunch - a very good one, interestingly enough. Spent the rest of the day resting and drinking in the IVs. Dinner was terrible, but more in line of what I expect from hospital food.

I wasn't really able to sleep most of the night, not that I expected to with people checking on me all night long. Had to have another pain killer about 2AM, and had tossed up what I had eaten for dinner about 1 AM. Stomach still nauseous.

5 Sep

Overnight stay is the standard at the Dallas VA for IPP, mostly due to the antibiotics. Got my first look and feel: Even as half inflated, the thickness is there. Length? Well, I was too swollen to tell. Not much bruising yet.

The docs made their rounds about 8AM, and pulled the catheter and the drain, which had almost nothing in it - just a couple spots of blood. After that, I was allowed to get dressed, and to get up and walk around carefully. Unfortunately, my wife had my clothes and didn't make it back until about 9AM. She picked up my prescriptions (more antibiotics - Rifampin and Cipro, a stool softener, and hrdrocodone) while I was dressing. Since I was required to stay through lunch, that wasn't an issue. The most difficult thing to do was take a simple pee. I was getting out very little at first, due to both the inflation and the swelling. Managed to void about 500cc before lunch, so looked at lunch, decided just to pick at it. Left the room about 1 and went through discharge processing while my wife went to get the car. The trip home was both uneventful and relatively comfortable, although we did stop to pick up some Ginger Ale for my still upset stomach.

Once home, I spent the rest of the day resting. Note: I had thought I'd want to spend a lot of time in my recliner, but it turned out to be difficult to get out of with assistance unless I liked pain. Peeing got easier, but, as others have noted, I was aimed straight out. Bring the urinal home with you. Besides, it's interesting to see how much you're actually getting out each time: I started around 100cc, and was going every 45 minutes or so. It actually felt like my bladder was completely full each time.

Not a lot of appetite that day.

4 Sep (Thursday)

Took a good look, using a light and a mirror. There's a lot of bruising, and still some pain. Took the hydrocodone at night to cut the discomfort and sleep. At this point, pain was usually about a 3 with no pills, but higher at night.

5 Sep (Friday)

Even more bruising! My entire set of equipment is now one completely solid bruise! The swelling is subsiding, as is the pain; peeing is still a bit of a problem, but the volume is coming up - to about 125 most of the time. Progress, albeit slow. Wife did her first inspection today, and pronounced the thickness and hardness to be "mmmm."

6 Sep (Saturday)

Bruising is less. Peeing is more. Pain is much less (a 0 most of the time.) Still wearing the jock strap, but, since I’m still sticking straight out and still to buried from my excess weight and the swelling to bend, the jock strap is really irritating. Doing without scrotal support didn’t work, and briefs don’t have enough support. Changed to wearing the strap over the softest briefs I could find, and that worked fairly well to cut down the chafing.
Another interesting thing started happening: sometimes, with change of position, I am getting a bit harder, as if the corpus cavernosum urethera is still getting enough blood flow to expand reasonably. My glans also swells at these times.
Still need the hydrocodone at night. Cipro and Rifampin are still upsetting my stomach, so I’m taking the pills with a couple of Pepto-Bismol tablets. Seems to work well enough.
Still showering with the disinfectant soap they gave me.

7 Sep (Sunday) – 12 Sep (Friday)

Just taking it easy today. Vegging in front of the tube or working on the computer. Same-o, same-o: less pain, less bruising, etc. Was able to drop the hydrocodone and move to Naproxen by

13 Sep

Dropped the jock strap in favor of just the briefs, but found I still needed it at night. Peeing is up to 500cc now, pretty much mu norm when I’m “full.” Upset stomach went away when I finished the antibiotics. Now drinking lots of water without any discomfort. Feeling well enough (libido is back) that we had a very nice, long makeout session in the evening: shades of being teenagers again. Just no “final reward” until the doc’s clearance. Don’t really know how we’ll make 6 weeks like this….
Swelling is to the point where I can see that, if I lost any length, it’s minimal.

14 Sep

Was feeling well enough to get up and go to church, but didn’t drive. Dropped the sweat pants for normal pants, which are now loose enough to be comfortable. I feel like I’m running around like a teeny-bopper with a hard-on all the time, but I don’t have any books to carry in front of me. Fortunately, for a couple days I’ve been more flexible, so I can bend up like they want as well as aim, so the urinal is only for measuring now. Because the swelling is way down, I’m also not quite as thick (still at half-full). Still quite hard, however. Still getting additional hardness when changing positions some of the time. Same thing now happens around my wife….

15 Sep

Less swelling, less bruising. No pain. Dumped the jock strap even at night.

16 Sep

NO BRUISING LEFT! There is still some swelling in the scrotum, especially around the pump. I still can’t really identify the parts of the pump, and it feels both heavy and hard. No other changes, but was able to comfortably drive to Dallas (40 miles) for the evening.

I’ll be doing additional updates as warranted instead of daily. Next appointment is on Monday (22nd) and I hope they deflate this thing some, although I am getting used to it.
Age 66. Coloplast Titan (20cm + 2cm extension) with 135cc saline in the system. Implanted 4 Sep 2014 by Dr. Gregory R Thoreson, Chief Urology Resident and Dr. Tausch, his supervisor at VA Hospital, Dallas.

lewisbl
Posts: 151
Joined: Mon Jul 21, 2014 10:37 am
Location: Huntsville, AL

Re: Finally got it done!

Postby lewisbl » Wed Sep 17, 2014 6:49 pm

Congrats VietNamVet! LOL! (GulfWarVet) I was implanted with the AMS 700 LGX on Sept 15. We had some of the same problems. My burning while peeing is gone. I am having big problems wearing the support. I am pumped up at 5 1/2 inches length and 5 3/4 girth. The support is too tight on me. I have a lot of soreness. My wife thinks it's still swollen, LOL! it's not she's in trouble once it heal. Keep posting so I will know what to expect.
AMS LGX 18 CM with 4 RTE Implanted SEPT 15, 2014, by DR Flatt. Failed SEPT 15, 2017
AMS CX 18 CM with 5 RTE revision NOV 27, 2017, by DR Flatt.
AMS CX 18 CM with 5 RTE revision MAY 8, 2017, by DR Flatt.

VietNamVet
Posts: 10
Joined: Sat Sep 06, 2014 12:14 pm

Re: Finally got it done!

Postby VietNamVet » Mon Sep 22, 2014 2:54 pm

19 Sep

Spent all day on my feet (working) with no discomfort and no ill effects. I all but forgot the implant was there.

22 Sep

Went in for my "two-week" check today. It was really just a wound check. The good news is that everything is proceeding "textbook" still, with absolutely no signs of infection.

The bad news is that I still have to shower for two two more weeks until the stitches dissolve. I was hoping to be able to soak in a nice warm tub (I've been a tub person since Vietnam - little luxuries, you know). That, and they're leaving me semi-inflated for another 4 weeks until they activate it on 17 Oct. So, I have another 3 1/2 weeks of running around like an 8th grader in heat.

There's still some swelling (internal) around the pump, so I can't really make lout the parts of it, but they tell me that's still a normal reaction to a foreign body in the scrotum and will go away soon. The pump is beginning to be easier to move around when it gets into the wrong place. Pain is virtually non-existent, and peeing is completely normal. I can even aim well now. I am, however, still a bit chafed from being in an unnatural position, but it's getting better.

Got a hint from the doc today about the use of a jock strap for scrotal support (with they'd told me this a couple weeks ago): cut a hole for the penis to relieve the pressure directly on it. I suggest you check with your own doc before doing so, as they may have different advice, depending on how they deal with the positioning of the implant after surgery.

I don't anticipate posting anything else until after it's activated unless something unusual happens.
Age 66. Coloplast Titan (20cm + 2cm extension) with 135cc saline in the system. Implanted 4 Sep 2014 by Dr. Gregory R Thoreson, Chief Urology Resident and Dr. Tausch, his supervisor at VA Hospital, Dallas.

sabaone
Posts: 117
Joined: Tue Sep 27, 2011 12:21 am
Location: Jerusalem, Israel

Re: Finally got it done!

Postby sabaone » Mon Oct 13, 2014 11:53 am

Thanks VietNamVet for the extensive descriptions both pre- and post-surgery. I'll be going in at the end of this month for the Coloplast Titan, and you've given me a lot of food for thought...and ideas for more questions for the operating urologist.

Dennis
DOB:2/1940; 4 Oct 2011, date of Robotic surgery
Gleason 3+4=7
Cancer confined to one lobe, did not enter capsule

VietNamVet
Posts: 10
Joined: Sat Sep 06, 2014 12:14 pm

Re: Finally got it done!

Postby VietNamVet » Wed Oct 22, 2014 6:42 pm

17 Oct 2014

Had my 6 week check. Passed with no problems. I'm still a bit sore each time I pump it up, but that gets less each time. Strange as it might seem, I am about 1/2" longer than before the surgery, as measured against the results from using a pump. Girth, however, is 1/2" less, but I'm told that will increase somewhat with time and use. As far as use, well, the wife likes it. Enough said! Lot's more practice using it in the near future....

This was definitely worth doing.
Age 66. Coloplast Titan (20cm + 2cm extension) with 135cc saline in the system. Implanted 4 Sep 2014 by Dr. Gregory R Thoreson, Chief Urology Resident and Dr. Tausch, his supervisor at VA Hospital, Dallas.


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