Dealing With Prostate Cancer: (Part 3)
Soon after finding he had prostate cancer, William Martin underwent surgery. What follows is an account of the first few days of his recovery.
Editor's note: William Martin is a professor at Rice University who has lectured on sociology and wrote books on religion, as well as a memoir about surviving prostate cancer. This series was excerpted from his book, with permission.
Soon after I woke up, I was wheeled back to my room, where Patricia was waiting. She reported what Dr. Scardino had told her after the operation. As best he could tell by visual and tactile examination, my tumor had been about the size of a finger joint -- much bigger than a BB. Unlike approximately 90 percent of prostatic tumors, it had been located in the center of the gland, which helped account for the severity of my urinary difficulties and explained why neither digital rectal exam (DRE) nor transrectal ultrasound (TRUS) had picked it up. Fortunately, it also meant that it was less likely to have penetrated the capsule. We wouldn't know about that with certainty until early January, when the pathology report would be complete, but the signs were excellent. In all likelihood, I had been cured of prostate cancer.
With that news in hand and all pain still in abeyance, we began to examine the patient. First, of course, was my scar. Richard "Racehorse" Haynes, a colorful Houston criminal lawyer, tells of having questioned a woman who had been shot by the wife of a jealous husband. When he asked her to confirm that she had been "shot in the fracas," she replied, "Actually, it was between the navel and the fracas." Well, I had a neatly sewn scar running the full distance between my navel and my "fracas." A nurse commented that it looked good enough to have been done by a plastic surgeon, and I began to feel quite proud of it.
Next, we checked out the catheter. On first glance, I wondered if Dr. Scardino had failed to give Patricia a full report. My genitals, responding to both the trauma and blood loss, had shrunk and receded into my body to such an extent that they would surely have been safe from Lorena Bobbitt. Close inspection, however, reassured me that all the vital parts were there. It also revealed the catheter tube that would drain my bladder continually, minimizing leakage of urine into the repair site until the bond between the bladder neck and urethral stump became watertight. The tube was thicker in diameter than I had expected, but there seemed to be room for it, and a check of the bag hanging on the edge of the bed confirmed that it was doing its job.
My final new appendages had been explained to me, but I had not yet seen them in action. These constituted a Sequential Compression Device designed to prevent blood clots from forming in my legs while I was bedridden. My legs, in elastic stockings, were encased in plastic coverings outfitted with inflatable panels, like a child-sized swimming-pool raft. An air compressor huffing away under the bed filled these air-pockets sequentially, from the ankles upward, then relaxed and repeated the cycle, making sure my blood was never able to hang around in some joint and form a conspiracy against me. If the leggings got too warm, a flick of a switch would send cool air hissing through dozens of small holes.
As one can imagine, I felt helpless and entirely dependent upon the kindness of strangers, but I also felt an overwhelming sense of relief, joy, and gratitude. All things considered, this had been a fine day.
When Patricia left for the night, I tried to sleep but had difficulty, probably because I'd had a five-hour nap that afternoon. I was neither edgy nor in pain, and spent much of the night planning my course for the spring semester. Cancer cured; back to work.
On Tuesday morning, David Bybee came to see me during his rounds. When he asked how I felt, I told him that the only time it hurt was when I got an erection. He said, "That's almost a sick joke," but he was genuinely tickled, which pleased me.
A little while later, Dr. Scardino came in for a quick visit before departing for Sicily. He repeated what he had told Patricia, adding that, although the nerve bundles had been arranged more tightly along the edge of my prostate than he hoped, he felt he had not had to damage even a single nerve. "I don't know how it could have gone any better," he said. Sometimes that's the way things happen in an unfair world.
The rest of the day went reasonably well. I had a dozen or so visitors and I talked on the phone to others. I was still giddy with relief, but the end of the day the joys of hospital life were fading and my system was beginning to rebel against the insult it had suffered. I was not allowed to eat or drink anything, but the constant trickle from the IV bag kept me from getting hungry or thirsty. It did not keep my mouth from getting dry, so I was permitted to suck on a small cup of ice every four or five hours and, as a special treat, to rub my gums and tongue with a lemon-glycerin swab.
When I sat up, I invariably became nauseated, but since I had nothing to lose, it resulted in a dry heave that produced a notable strain on my stitches, causing me to clutch desperately to the extra pillow Aaron had recommended I order. Bad as it felt, this was garden variety nausea that usually passed quickly, but I thought of cancer patients who undergo an extended regimen of chemotherapy and wondered if the nausea that often accompanies it is not worse than pain.
The nausea, I learned, was a side effect of the pain medicine, as were chronic hyperacidity, a low-grade headache, and near-constant hiccups. Alteration of the analgesic mix reduced the acidity and headache. The hiccups, I was told, could be cured with thorazine, a remedy I declined from fear it might make me a less interesting person.
By late Tuesday evening, I was exhausted. To ease the passage from wakefulness, I reached for a crossword puzzle book I had brought with me. After a few minutes in the world of aretes, ediles, Otoes, and long-dead movie stars -- a characteristic that suggests a strong correlation between the ages of crossword enthusiasts and prostate-cancer victims -- I slipped into unconsciousness and slept a solid six hours without changing position.
Wednesday was harder and Thursday marked the nadir of my stay. The nausea and hiccups continued, and lying in one position, knees flexed and back tilted upward to avoid straining the stitches, grew increasingly onerous. Not until midnight Wednesday did a nurse named Bob help me find an alternate position, which gave me some relief. All the nurses were cordial and competent, but seriously overworked. Because a number of patients had scheduled surgery with an eye toward a pre-Christmas recovery and a 1993 tax deduction, the urology ward was packed. Unfortunately, this coincided with a recent cost-trimming cutback in the number of nurses per shift. On several occasions when I truly needed a nurse, the response was slow and accompanied by a frustrated apology. Repeatedly, when I was being attended to, my nurses would receive calls to come to other rooms, which meant they would also arrive late and apologetically at the next patient's room. To complicate matters further, the entire ward was scheduled to be shifted to another floor on Saturday, and preparations for the move added to an already frenetic atmosphere.
On Thursday, I took the first difficult steps of my post-prostate era, with a nurse holding onto one arm and the other steadied by a bent and rickety IV/catheter pole -- an ironic symbol of my current state, I thought. If the "Prime Time Live" crew had visited this ward, I doubt Sam Donaldson would have criticized Methodist Hospital for its luxury-hotel atmosphere. My last two visits to this institution had been to the orthopedic surgery unit, from which most patients walked out smiling a few hours after their operations, and to the maternity ward, with its warm and joyful affirmation of new life. In stark contrast, the urology ward is filled with old men in pain, depressed by their impotence, evidence of their incontinence hanging in full view, and their naked butts and hairless legs sticking out of backless hospital gowns. These, I thought, are "the few, the humiliated, the Urine Corps." One look at my new peer group moved me to suggest that it might be best if would-be visitors just sent a note or called. Men look better in our power suits.
As Nurse Bacero had warned me, the guts are the last people to wake up after an operation, but they would have to wake up before I would be ready to go home, and that meant they would have to have something to work with. On Thursday, I began to receive food trays. What I got seldom matched what I had checked on the order form, but they were all items from the restricted menu, and since no one form of water seemed much more promising than any of the others, that didn't bother me. On Thursday evening, after a walk down Hell's Alley, I ingested another of the chef's "clear" dinners, and sat in a chair from the beginning of network news to the end of McNeil-Lehrer.
When I got up, I discovered that the epidural catheter had come out. I was scheduled to keep it a day longer, but the pain-management technician decided to switch me to Percoset, a synthetic opiate. I wondered if losing my magic morphine machine meant I would have a rough night, but the technician assured me I could order a shot of Demerol or morphine any time I needed it. "There is nothing heroic about enduring pain," she said. "These drugs are made for precisely this purpose. Ask for them if you need them and don't worry about how much you should take. It's your body. What is normal for you is normal." In fact, the Percoset was quite adequate and removing the needle from my back meant I had one less tube to consider when I needed to move.
By Friday, I felt I had turned the corner, but the teams of residents and technicians who visited me each day sought tangible evidence that my gastrointestinal tract was back on the job. Specifically, they wanted a good-faith show of flatulence. I had quickly grown accustomed to having uniformed nurses give me sponge baths and change the dressing at the point where the catheter tube exited the head of my penis. I never did get used to having a perky young woman in street clothes ask if I had managed to pass any gas yet.
The last time anyone had actually encourage me to fart had been on a Boy Scout camporee and, if I remember correctly, matches were involved. (For any woman who may be reading, it's a guy kind of thing.) I regarded their interest as bordering on the surreal, but when I finally managed to sing the song of the nether larynx, though it was hardly enough to hold back on an elevator, their joy was unmistakable. One auditor actually used the phrase, "music to our ears." Small victories.