April 13, 2009 Recovery Begins - Docs orders

surgery: 7 days ago

catheter removal: 3 days ago

pain medicine: tramadol every 6 hours for pain

laxative: docusate sodium 2 daily for 10 days

blood flow: Viagra 3 times a week, 100mg

adult pads: as required

exercise: 1 mile per day walking, 300 kegels

follow up: 6 weeks

At this point the physical exhaustion is still there sleeping 10-12 hours, the pain is starting to subside and become more localized in the incisions (muscles) and the pelvic floor, most of the anesthesia physical effects have subsided, still awaiting the bowels to activate.

The key is to stay hydrated, but mentally you want to control urine flow so obviously you are automatically drinking less, DRINK. Hydrate and manage your trips to the restroom, plan on one every 30-40 minutes. Attempt to stop and start flow while urinating as well. Be aware, if the urine flow stops either you're dehydrated or you may have blockage. If it is blockage notify your surgeon immediately, you will be reinstalling the catheter. If your urine becomes bloody, this is a key sign that you are doing too much, back down and rest. It is nothing to be too concerned with unless it is a measurable amount.

As for physical exercise, NONE for 4 weeks, I assume each patient may be different. No running, no lifting more than 5 pounds, no core exercise, no stretching, no sexual stimulation. The walk is prescribed for at least one mile per day, the more you are stationary the sorer and tighter you become. The kegels which exercise the pelvic are key for the urine control, 300 per day. This is not an easy goal to meet. I did this prior to surgery so I was somewhat prepared for the tenacity of these exercises, they become much different post-surgery.

As for medicine, down to 1 pain pill as needed, the laxatives are must at this point and the Viagra is prescribed to increase the blood flow in the surgical region. I must add that the Viagra is only for blood flow at this point, directions were explicit that if anything were to occur it was not to be utilized - cold shower - this is medicinal recovery time - 4 weeks.

Incision care, showering is fine, no hot tub, bathtub or swimming pools for 4 weeks. The incisions are sealed up with glue. I have four incisions for the daVinci robot, 1 incision for the removal of the prostate and 1 drain hole for post-op.

Using the restroom for bowel movements, DO NOT FORCE anything (not gas nor excrement), you do not want to stress your bladder reconstruction during the healing process. Just let the laxatives do their job, if you slowly lean forward and then sit upright, alternating this will assist the laxatives and bowels.

The key is to relax and incur as little outside stress as possible. Stress will become your worst enemy. And I promise you this is not only physically stressful but psychologically and emotionally as well. So you will need to find ways to manage the stress.

I don't anticipate that this phase is going to be an easy trial.