Steve S.

US, USA

Background

I was diagnosed at age 49 with a Gleason score of 6 (3+3), staging = T1c and a PSA = 4.8 in August 2007.  My biopsy showed 2 out of 20 cores were positive for cancer.  I had a negative biopsy in February 2006, but a spike in my PSA in June 2007 caused my urologist to do a second biopsy whichcame back positive.

I had robotic prostatectomy in mid November 2007 performed by Dr. Samadi.  Post-op results indicate: (1) negative margins, (2) confirmed Gleason score of 6 (3 + 3), (3) staging = T2c and (4) PSA < 0.05.

My Pre-Operation Experience

Like many of you, I was devastated after my diagnosis.  I was actually physically ill for 5 days.  After the initial shock, I began a journey – – aided by adrenalin – – to learn as much as I could about the disease.  It was a bit daunting at first as I began to realize – – in spite of this being the second most common cause of cancer among men – – that there were no easy answers.  One of the first things I did was to race to the bookstore where I found a gem of a book (Dr. Peter Scardino’s Prostate Cancer Book).  This was a great resource for many of my questions.  Next, I went though a process of interviewing the top surgeons for robotic prostatectomy in the tri-state area.  Dr. Samadi was the fourth surgeon I met over a 3 week period and I decided on the spot that he was the best.  Almost immediately upon meeting him, I started to feel a sense of comfort about the treatment of my disease.  While the other surgeons were all qualified to perform a robotic prostatectomy, none of them had ALL the key credentials that Dr. Samadi had, including: (i) experience in all three types of prostatectomy (open, laparoscopic and robotic), (ii) performed over 1,000 robotic prostatectomies, (iii) he’s an oncologist, and (iv) he’s has an unbelievably compassionate bedside manner.

My Robotic Prostatectomy Experience

Day of Surgery – My surgery went very well and my recovery from the surgery (i.e. the surgical wounds) itself was quite uneventful.

Days 1 to 7 – were difficult for me, largely due to pain assopciated with the catheter.  I am convinced that the catheter experience (and one’s tolerance for it) is 100% related to the anatomy of each person.  I had a particularly difficult time with pain management in days 3 & 4, where I used the local anesthetic (Lidocaine – the stuff Roger Clemens had injected into his rear end) every two hours for 48 hours straight and never slept more than during brief naps.  After this I decided to take two percosets before bedtime, and wound up having a bad reaction to the drug (hallucinations, pinching in my fingers, nightmares, etc.).  After lying awake all night while the meds worked though my system, I crashed all day the next day, and finally awoke with manageable pain.

Day 7 – the catheter was removed.  A very emotional experience.  I decided to stay in NY city that night in case I had any adverse side effects (e.g., retention), but fortunately all went very well.

Weeks 2 to 3 – I had 100% incontinence for the first two days after the catheter was removed, so I wore a diaper.  I was just happy to be without the catheter and without pain, so I was content to tolerate the diaper.  Beginning on Day 10, I basically wore pads starting with 5-6 per day, and slowly (by Day 21) working down to 2 during the day and one while asleep.  Also, between days 15 and 21 I had several spontaneous erections, but did not act on them.

Week 4 – On Day 23, I was diagnosed with a bladder infection and took cipro for a week.  My main symptom was a burning sensation at the end of urination that was concentrated mainly at the tip of the penis and the last few inches of the urethra.  The cipro improved, but did not eliminate, the symptoms.  On Day 25 I had an erection and a full orgasm.  It was a strange experience without the ejaculation, but in ALL other respects it was a normal orgasm.  Thank God and thank Dr. Samadi!

Week 5 – On Day 30, Dr Samadi determined my infection was gone and prescribed a medication to minimize the burning sensation (phenazopyridine, it’s a dye that turns your urine bright orange).  I took this for a week and the pain subsided to a minimal amount.  On Day 35 I began weightlifting again (staring at very light levels).  Heavy weightlifting has always been a big part of my life, so I was anxious to get back to it, albeit on a gradual basis.  My goal is to return to 75% of my pre-surgery levels over 4 to 6 weeks.  I’m not sure I want to return to 100% levels ever again, because my heavy weightlifting was becoming less and less tolerated by my aging body (e.g., 450 pound bench press was causing pain in my testicles).

Week 6 to 7 – I went back to work part time and had to adjust to the incontinence.  I continue to use 2 pads during the day and one pad while sleeping.  My experience is that after 5-6 hours at work sitting in my office, I tend to need to “go down the hall” more and more frequently to the point where it gets to every 10 to 15 minutes by mid-afternoon.  I also tend to wake up at 5AM to urinate and I’m not able to fall back to sleep.  I’m thinking about shifting my workday to 7AM to 3PM, rather than 9AM to 5PM, with the hope that the afternoon incontinence will be less of a problem.  My incontinence has not improved much for several weeks, but I continue to do the Kegel exercises 2 to 3 times per day.

Dr. Samadi said it’s not uncommon to have rapid improvements with the incontinence in the beginning followed by a plateau, then followed by a rapid improvement period.  I am confident that I will return to my pre-surgery bladder control levels in due course.
He also said some of my incontinence is “stress incontinence” and some is caused by an overactive bladder.  To help with the overactive bladder symptoms, he prescribed sanctura.

Summary

I recall discussions (with Dr. Samadi and other patients) about the “goal of hitting the prostate cancer “trifecta” (no cancer, no impotence and no incontinence).  Right now I have hit the exacta (no cancer and no impotence) and I am truly grateful for that.  I thank Dr. Samadi and God for that everyday.  Just 6 weeks ago, I was concerned about my life let alone impotence or incontinence.  I am confident that my incontinence will improve and I will hit the trifecta soon too!

I wish the rest of you similar success.  Please feel free to ask me any questions about my experience.

Thank you Dr. Samadi and staff.

Thoughts About Dr. Samadi and His Staff

I echo the comments made by many of the others about their experience with Dr. Samadi and his staff.  Dr. Samadi is a unique person having reached the pinnacle of his profession, while at the same time treating all his patients with compassion as though they are members of his immediate family.  It’s unheard of in this day and age to meet someone like him.  Who ever heard of a top notch surgeon giving his cell phone number to his patents and asking them to call him at any time?  When I told the priest at my church about Dr. Samadi, he was visibly moved.  In fact, he called me a week later to ask if I wouldn’t mind speaking to a parishioner who was recently diagnosed with prostate cancer.  That parishioner is now being treated by Dr. Samadi.

I also had a wonderful experience with Dr. Samadi’s staff (Anne and Rosy).  They are always willing to listen and help and offer words of encouragement.  Just like Dr. Samadi, Anne gave me her cell phone number and was gracious enough to answer my questions at all hours.

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