Gathering information for the decision time

12 years 5 months ago - 12 years 5 months ago #40146 by mmc
I'm not really the expert on docs but Dr. Koch is supposed to be one of the best in the world from what I've heard. If he is the one who said to expect to lose function and he didn't qualify that with something like "for a while" or something like that then I'd certainly suggest asking him why he said that.

I'm pretty sure others here even had Dr. Koch do their surgery so hopefully one of them will notice this and chime in.

Keep in mind that all of us here are either active bladder cancer patients, survivors, or folks who have helped as caregivers to patients. We are here because we want to help folks like you who have been recently hit with this. We were where you are. As for me, this site and the people here were a tremendous help for me. Some of them are no longer even here. Some lessons have been learned the hard way and those of us here want to try to help new folks not to repeat mistakes of others (including ourselves in some situations).

We are not specialists in everything but we are (as you are now) quite motivated to learn as much as we can and to share that knowledge. I sincerely hope that you find that useful for you.

All the best!
Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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12 years 5 months ago #40145 by Groucho Marx
Replied by Groucho Marx on topic Gathering information for the decision time
So where do you come by info on outcomes by doctor? How does Dr Koch at the IU med center compare to the Cleaveland clinic? Pittsburgh is a 6 hour drive from here. I just happened to be there when the crisis came.

May have been just as well. My confidence in my local urologist is zero or less. Since last spring when she sent me home doing nothing about the blood in my urine, I have gone a lot of discomfort and pain.

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12 years 5 months ago #40144 by mmc
Groucho,

If your doctor is assuming you will lose function, I would suggest another doctor. You want someone with a LOT of experience. That would be a surgeon that does more than 50 of these a year. The nerve sparing part needs to be something they also do all the time and have a good track record. No point going with a surgeon who can't do the job.

The top surgeons have the highest success rate and lowest complication rate. There is a study or two on that somewhere but I can't find the link right now.

Maybe someone closer to your neck of the country can chime in with recommendations on doctors/hospitals. Pretty sure Cleveland Clinic is still one of the top for bladder cancer. Not sure which docs. Sloan Memorial is ranked as one of the top (if not the top in the country). Further to go but that's something to consider.

Best of luck,
Mike


Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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12 years 5 months ago #40143 by Cynthia
Replied by Cynthia on topic Gathering information for the decision time
I think what you will find here is as real as it gets. People that have been handed a bad situation who have made the best of it. We will not tell you it is easy or that it did not changes our lives but we can tell you many of us (the lucky ones) have made it and are thriving and enjoying life.

When ever I was feeling like a drama queen about the unfairness of life all it took was a short ride in an elevator to pediatric infusion and I would stand for a few minutes and watch them play as they carted around their infusion units with them and I would gain personal perspective on fair.

I have an Indiana pouch and my stoma is in my navel, if I had a bikini body (I don't) I could still wear one. I cath every three to five hours it depends on how much I drink. I can feel when I need to cath it is a sensation of fullness in the area of my pouch. I wake up once during the night like clock work between two and three and go then sleep until morning. If I let it go to long I will leak and that gets me up and going when I feel the call. I carry my supplies in a cosmetic pouch in my purse ( men I am told solve the problem with a baggy in a pocket). I carry disposable catheters, small packs of lubricant and a small bottle of antibacterial hand cleaner. I find it rather nice not to have to deal with dirty toilet seats. The first time I went had to go in the woods while hiking I though "Damn men have always had it made". There is something to be said for urinating standing up once I got the aim thing down pat. I can honestly say and this is as real as it gets that once all was healed, trained and gotten used to that my diversion has not changed my life at all.

Sexuality is different of course between men and woman, but for us there is ramifications of this as well. A complete hysterectomy, vaginal scaring and altered body image have their own issues. We as a couple had to be willing to work through the challenges and we did. I have talked to both females and males that have grown closer to their spouses because of this. Talking to your doctor as many of us did about nerve sparing is the first step, afterwards as the men here can tell you there are options.

We will never tell you this is an easy situation with easy fixes but we can tell you it is doable. That is what this website is all about sharing experiences and offering support. If you were to ask a woman in the middle of labor if she thought it was all worth it I am sure you would get a different answer once she had delivered. We are on the other side of a Radical Cystectomy and maybe we make is sound easy and it wasn't but it was worth it.

Cynthia Kinsella
T2 g3 CIS 8/04
Clinical Trial
Chemotherapy & Radiation 10/04-12/04
Chemotherapy 3/05-5/05
BCG 9/05-1-06
RC w/umbilical Indiana pouch 5/06
Left Nephrectomy 1/09
President American Bladder Cancer Society

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12 years 5 months ago #40142 by GKLINE
Replied by GKLINE on topic Gathering information for the decision time
Groucho
I was being real .... for me.
I have a neo bladder that works like a normal system...no bag.
I DO have leakage problems still (3 years after surgery) but they are mostly at nite and I accept that as a choice for Life.
I DID NOT have the ability to get an erection on my own for a year (even WITH nerve sparing surgery) I still do not have total confidence in myself.... so I take the magic pill for confidence.

As for those rose colored glasses; I have survived and live a semi normal life because of those glasses. Do I have problems associated with this cancer...... You bet!
If I wanted to let those problems get to me, I sure could.
I WILL NOT let the erectile dysfunction and leaky plumbing get me down!

Everyone finds their level with this crappy disease. I just will not let this crappy disease put me under water!

We CAN be a sarcastic bunch here at times..... But that is the only way we can keep from going totally bonkers.

Seriously. Take it slowly. But keep perspective. Each day we see folks with much worse afflictions than ED and incontinence. A sense of humor about yourself is mandatory. The BEST jokes are the ones that use ourselves as the focus.

Sincerely
George Kline

Light a man a fire and he is warm for an evening.
Light a man ON fire and he's warm forever.

08/08/08...RC neo bladder
09/09/09...New Hip
=
New Man! [/size]

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12 years 5 months ago #40141 by mmc
I am real. I lost function for a while but then it came back. There are many things that can be done in the interim. Pills, shots, etc. Best to talk to your doctor about that in detail and he can explain all the options.

As for me, my first priority was not being dead. Then I would figure out the sexual function part. Dead people don't get any sex as far as I know so my chances were going to be much higher by being alive.

That's real.

I had complications with my neobladder so I have to catheterize each time I go. Most people don't have to do that and they either don't have to catheterize at all or just periodically.

Before I had the complications, I could urinate standing up but I could empty better if I sat.

If you have an Indy, you have to cath each time. If you cathed a new every time you wouldn't have to sit either. If you get an ileal conduit you don't have to sit either. Stoma placement can be different for each person. Many with India Pouch can get them in the naval so they don't show. Ileal conduit tends to be more toward the side. Google "Ileal Conduit" and select images and you can see examples.

The schedule is very important when you are new to the pouch (neo or Indiana). You have to slowly stretch it out to increase the capacity.

After that, if you go too long you can overstretch the pouch and wind up with a floppy bladder that you won't be able to empty easily. You get a sense of discomfort with any type of pouch as well. It's not the same but there is a feeling of being full in the abdomen. Just like a regular bladder, at some point you'd just start leaking if you went too long.

Hope that helps.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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