Early days after surgery. Some questions

User

Posted 04 Aug 2019 at 16:51

Hi again and thanks for the latest replies and info. He's not staying in bed as he wants to get up and walk a little (which he knows he should) - and the almost hourly to two hourly little trips out to the loo (regarding the catheter bag) and then out to the kitchen and back are helping with the bloaty gas he's now suffering, especially after eating. He has virtually no appetite and everything is in toddler portions. I've been careful to ensure an increase in fibre but trying to get enough fluid in is definitely going to be the thing as he does need some reminding.... (talking of which... goes to remind...)
As he has had so little to eat since the day before surgery we are not thinking constipation is a problem - yet - but if no action by tomorrow then he's going to have one of the laxatives.
He's had a bit more pain today and was feeling hot to the touch but he said was feeling cold so I'm hoping he's not brewing an infection. I'm carefully logging all the paracetamol as he can only have 8 in 24hrs and we are up to 5 at the moment having split the last dose so he can have another half later then the final 2 any time before midnight.
As for urine colour, it is a little dark but not overly so. I have also seen it paler. Last night was the first night home with the catheter and I was unsure what to expect so was setting my alarm 2 hourly to check it had not kinked, leaked or worse! So now I'm completely knackered as well! Actually it was all fine. The bucket thing became a saga in itself! Each bucket I brought in just seemed too small so we now have the cleanest giant builders muck bucket sitting beside the bed!
I am now sort of getting into a routine with this and but it makes me realise just how much would have gone on in hospital in days gone by for this sort of surgery.
Thanks again everyone.

User

Posted 04 Aug 2019 at 21:13

Hi Waffles, I had my surgery in March 2018 all I can remember about the catheter was it was a little uncomfortable at first but I gradually got used to it. However you need to get his bowel moving he dosen't need constipation as this will put a strain on his already sore stomach, also straining to go can cause issues with the catheter. As for the gas thing that will ease after a few days especially with gentle walking etc. He must not lift or carry anything heavier than a cup of tea for about six weeks and should not try driving for at least four. All I can tell you is it all gets better with time just don't let him force himself to get better just help him especially mentally as the mental healing can be just as bad as the physical.

Best wishes to both of you

User

Posted 05 Aug 2019 at 15:45

Thanks Ants. We had a bit of a concern this morning as he was seeping a bit of bright red blood on the outside of the catheter but this has now stopped. He thinks he might have strained a bit trying to use the toilet - which he knows not to do but anyway... . He says he does not feel constipated but is a bit worried that he has not been yet - however - his food intake has been very small so its not really surprising. He's had one of the laxatives this morning but no action yet. It's a waiting game.
Anyway on the plus side his pain seems better and he seems to be slightly more comfortable with things like getting up off the chair so onwards we go. He's also managing to eat little and often and is making a sterling effort to drink everything I give him.
We got to about 1.5 litres overall yesterday but from what we read the 1.5 - 2l is in 24hrs - and of course he's in bed for some of that asleep so actually he's maybe doing ok with that.
Thanks again.

User

Posted 05 Aug 2019 at 18:02

Hi waffles. Did he have a BM before leaving hospital?

User

Posted 06 Aug 2019 at 15:18

Erm… a BM?

User

Posted 06 Aug 2019 at 20:12

BM is probably bowel movement.

I would suggest that he should already be taking laxatives. I was given some in hospital. Lactulose for more liquid motions and Senokot senna tablets for moving it forward. The hospital prescription was 20ml Lactulose morning and evening, and 2 tablets just before bedtime. I am now 12 weeks after the operation and still suffer from constipation- I didn’t before. Initially it got better, then it was terrible so back on the laxatives. My current balance is 5ml morning and evening and1 tablet at nighttime. This after some experimentation. Initially you won’t want to stray too far from a toilet in the morning until you find how your body reacts. Everybody is different.

I am still fairly incontinent, but am learning to cope with it. Sitting and lying down is fine, but standing or walking is just constant dribbling. I am drinking a pint of water at each meal time. I was leaking fairly heavily down the side of the catheter before it was removed.

Good luck!

User

Posted 07 Aug 2019 at 16:23

He did not have a BM before leaving hospital but had one on the morning or the op then virtually nothing to eat after that. He is now having issues despite being discharged with laxatives which he has been taking for a couple of days. He spoke to his GP today who has told him to up the dosage and who is fairly confident things will resolve themselves.

User

Posted 07 Aug 2019 at 16:58

This is quite normal as all his intestines will have been moved and buggered about with to allow the robotic arms unfettered access to the prostate area. Afterwards, they just chuck all the pipework back in place, and then leave nature to take its course so the intestines find their way back to their normal location.

Do persist with the stool-softening drinks such as Fybogel, together with laxatives, and as his GP says, no doubt things will resolve sooner rather than later.

Best wishes.

Cheers, John.

User

Posted 07 Aug 2019 at 19:40

I ended up with adhesions after robotic surgery. This is where things that have been cut and bleeding heal against things they shouldn’t have. For 3 yrs I had awful pains first thing when I needed a poo or wee. Sometimes I couldn’t even sit up properly it was so sore. But then a movement would sort it. I guess it’s pretty much gone now after 4 yrs or I’ve got used to it. This could be your problem !!

User

Posted 08 Aug 2019 at 14:24

I'm sorry to hear that Chris. The surgeon told us to expect bowel probs as they said 'the bowel does not like to be moved' and the surgery presumably moves things about a bit. Things have certainly improved since the increase in laxatives and he's feeling so much better. The doc advised him this morning to now cut the dosage right back - mind you he had got to maximum. I'm so pleased for him as it was making him miserable and he was forcing down so much fluids he was getting fed up with that too.

We're now approaching catheter bag change day. Why do they need to be changed? All being well he loses the catheter next Monday anyway. Last night was a complete saga as the night bag was not filling at all and I could see no reason why. Checked and rechecked everything numerous times. The tube to the night bag stayed full and despite unhooking it all and flushing it (the tube and night bag only) with clear water, it did not resolve. So it was a hourly check on it all thru the night. Roll on Monday!

User

Posted 09 Aug 2019 at 12:05

Hi Waffles - I had my robotic surgery last Friday (2nd August). Most of the advice you’ve had is right on. One thing I would add is that he should adopt a position of squatting for emptying his bowel (like you would do in the countryside !) - on the Loo you can emulate this by putting a shallow stool or platform in front of the pan for your feet to rest on. I was able to make unstrained BMs this way and still do it like that - jut need a little gentle strain to get things rolling and expect a little leakage from the penis during the procedure.
On day 4 post surgery I was taken by surprise by the swelling around my penis and my scrotum which caused some discomfort - but I’ve noticed that it reduces by each morning after lying flat each night - I hoping this will dissipate in the next day or so - the whole groin and lower abdomen area is now various remarkable shades of yellow and blue !! I’m having a Cystogram on Monday followed by my catheter removal ( I hope assuming the Cystogram shows no bladder leakage).
Keep your pecker up and never feel shy about seeking help here 🖖

User

Posted 09 Aug 2019 at 12:39

John-Boy, squatting is how humans evolved to take a dump. We are not designed to do so from the seated position, and bowel, rectum and anus are not in the best position when seated.

You can achieve something similar on a regular toilet though. Sit on it normally, but then while keeping your bum on the seat, lean forward so your chest is on your thighs. Then you have the same thigh to spine angle as for squatting, which is how your rectum is designed to work. If you're reading a newspaper or your phone, rest it on the floor in front of you.

Edited by member 09 Aug 2019 at 12:40 | Reason: Not specified

User

Posted 09 Aug 2019 at 13:33

Quite difficult to get your chest onto your thighs so soon after major abdominal surgery 😬 Physios advise the step / stool method post-RP.

Edited by member 09 Aug 2019 at 13:34 | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 09 Aug 2019 at 14:35

Hi John-boy, Andy62 and LynEyre - I shall pass on the advice and tips although it's been good news since the laxative was upped to escape velocity. It's been ok since although he's going to continue with it but on a much smaller dose until things settle.

We decided to change the catheter bags a day earlier and this seems to have done the trick as I was only up once last night which was about an hour after we went to bed to check on it and after that I think we both slept ever the best since the op.

Back to hospital next week for the removal of it - and no doubt new challenges to deal with.

Thanks everyone. It's great to be able to post about this here.

User

Posted 09 Aug 2019 at 14:58

Waffles .Remember to take some pads with you to the hospital and a towel for the car seat, possibly a urine bottle all hopefully just in case. Keep the fluid intake going on the day of the twoc ,trial with out catheter. Stay calm and relaxed, him more than you. Hospital may give you some pads , from experience inadequate.

Thanks Chris.

User

Posted 10 Aug 2019 at 00:25

We decided to change the catheter bags a day earlier and this seems to have done the trick

what do you mean by this ?

can you clarify ?

I just connected night bag about 9pm. only one morning had the whole lot filled up to capacity.

if I remember correctly the 500ml ? leg bag was always in circuit. ie I linked the night bag. probably 2000ml at least to the end of it.

I kept the small bag with a few ml. left in after opening and perfectly clean tap/hands etc to ensure no bacteria could go 'back up into bladder'. probably a bit overkill..

Edited by member 10 Aug 2019 at 00:38 | Reason: Not specified

User

Posted 10 Aug 2019 at 14:15

Thanks colwickchris. The letter he has tells him to bring in pads and also tight fitting underpants plus loose trousers. Not sure about the tight pants as he doesn't have any - but wont be wearing boxers either.

To robgsr - when he was discharged home he was given a replacement leg bag and night bag - plus replacement tube to the night bag. We were told to change them on Friday but did it Thursday instead - the leg bag was starting to turn a pink colour - not the contents which were definitely white wine looking - but the bag itself - even round the edges. I'm certain it was not blood. We're guessing that after a while the acid in the urine somehow interacts with the bag.

Had a another saga last night with the new night bag not filling - I have tried everything and am putting it down to the line being too horizontal cos when he's in bed as when he stands up it starts to fill - however - it then stops and the tube to it just stays full despite various wiggles and squeezes. There must be a physics lesson here somewhere but I never did well with physics at school. There's also air in the tube in places.

Anyway, only a couple more nights of this - everything else is good and he is feeling so much better in many ways.

User

Posted 10 Aug 2019 at 14:36

Nip to the supermarket to buy a couple of pairs; the continence pads won’t work if they are not held securely against his body

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 10 Aug 2019 at 14:43

He has gone some underwear that seem to be ok with pads as he has been leaking down the side of the catheter and using pads for that. We have also stocked up on some disposable pants - mainly for nighttime.

How did people deal with night time leaks? I purchased a waterproof sheet thinking it would be easy to just wash and dry daily if needed - however - you can't tumble dry it - so in this weather it would have taken off by now.

We have also stocked up on plenty of disposable bed pads from Boots.

User

Posted 10 Aug 2019 at 14:45

Originally Posted by: Online Community Member

the leg bag was starting to turn a pink colour - not the contents which were definitely white wine looking - but the bag itself - even round the edges. I'm certain it was not blood. We're guessing that after a while the acid in the urine somehow interacts with the bag.

This sounds like the bacteria Serratia marcescens.

It's a common UTI bacteria and can grow in catheters/bags. You should ask if he should be given an antibiotic to target Serratia marcescens (it's often resistant to many standard antibiotics). May need better sterile handling of bags/tubes too.

It's also the pink or orange staining you often find around baths and showers - it can grow in soap residues.

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