Hello again

[Carlos]

Hi all

Not new here as I was around a couple of years ago. How is everyone?

A couple of things new with me. Have been using the libre since May 2020, which has made a massive difference. My hba hasn't changed by much, but the swings have reduced massively, going from about 77% in range when I started to 87% now.

I've continued with my cycling, getting in some reasonably long rides, including a couple over 50 miles.

Slightly less positive, my prostate started giving me trouble about a year ago. In the words of my doctor, it is unfortunately large for a 50 year old. Luckily it is just enlarged, nothing more serious. I am taking both tamsoulosin and finasteride, but it isn't making a great deal of difference, so now waiting for a urologist appointment in May.

Oh, and COVID finally caught up with me this week. The vaccine seems to have done its thing and I only had cold symptoms, not even a temperature, so I was surprised when the test came out positive. Symptoms are pretty much gone now.

Anyhow, glad to be back.

 

[Proud to be erratic]

Hello @Carlos ,

I have been having prostate problems since my major surgery back in Feb 2020. I eventually got a telephone consult in autumn 2021, which proved to be useless; the follow up report might have been about some other patient - but other than having my name on it I didn't recognise the detail described. I was parked by that Consultant - unhelpfully.

I pestered for more help after I was fitted with a catheter in July 2022 before emergency surgery for a bowel obstruction and they wouldn't remove the catheter before discharging me, since I was retaining urine in my bladder and only passing liquid because I was full and overflowing. All not much fun!

Anyway, after 2 day attendances at a urology day clinic for a Trial Without Catheter (TWOC), both unsuccessful, I was given a face to face Urology Consultant Appointment who did a "Dynamic Flow Evaluation". Interesting experience, no pain, very mild discomfort and entailed measuring the difference in pressure within my bladder from a very thin tube pushed up my urethra and outside the bladder from a similar pressure reading device up my backside. Within 30 mins I had a specific and conclusive diagnosis and confirmation that I needed a prostatectomy. This was done a few weeks later, by laser (actually called a Laser Green Prostatectomy); it's a procedure, rather than surgery. Because of my diabetes they kept me in overnight, just as a precaution. I left the next morning catheter free - and now, after 3 yrs since the problems started I finally am enjoying the relative freedom of bladder control.

One consequence is that I now not only have to rebuild my pelvic floor muscles (3 yrs not being used regularly) but also I'm having accupuncture to get the nerves around my pelvic floor to "wake-up" and restore their unheard and unknown dialogue with my brain in order to work with the nerves managing my bladder full signals. Who knew how complex this can all be!

Anyway, I feel so much better and "free". Also the accupuncture seems to be working; I've had accupuncture some 10 years ago and benefited from that, so I have no reservations about it now. Before you get to your Consultant in May establish what is going to happen and ask if a Dynamic Flow Evaluation will occur; demonstrate that you know what might be needed in order to get the corrective procedure (or surgery if that is what is needed).

 

[Carlos]

Hello @Carlos ,

I have been having prostate problems since my major surgery back in Feb 2020. I eventually got a telephone consult in autumn 2021, which proved to be useless; the follow up report might have been about some other patient - but other than having my name on it I didn't recognise the detail described. I was parked by that Consultant - unhelpfully.

I pestered for more help after I was fitted with a catheter in July 2022 before emergency surgery for a bowel obstruction and they wouldn't remove the catheter before discharging me, since I was retaining urine in my bladder and only passing liquid because I was full and overflowing. All not much fun!

Anyway, after 2 day attendances at a urology day clinic for a Trial Without Catheter (TWOC), both unsuccessful, I was given a face to face Urology Consultant Appointment who did a "Dynamic Flow Evaluation". Interesting experience, no pain, very mild discomfort and entailed measuring the difference in pressure within my bladder from a very thin tube pushed up my urethra and outside the bladder from a similar pressure reading device up my backside. Within 30 mins I had a specific and conclusive diagnosis and confirmation that I needed a prostatectomy. This was done a few weeks later, by laser (actually called a Laser Green Prostatectomy); it's a procedure, rather than surgery. Because of my diabetes they kept me in overnight, just as a precaution. I left the next morning catheter free - and now, after 3 yrs since the problems started I finally am enjoying the relative freedom of bladder control.

One consequence is that I now not only have to rebuild my pelvic floor muscles (3 yrs not being used regularly) but also I'm having accupuncture to get the nerves around my pelvic floor to "wake-up" and restore their unheard and unknown dialogue with my brain in order to work with the nerves managing my bladder full signals. Who knew how complex this can all be!

Anyway, I feel so much better and "free". Also the accupuncture seems to be working; I've had accupuncture some 10 years ago and benefited from that, so I have no reservations about it now. Before you get to your Consultant in May establish what is going to happen and ask if a Dynamic Flow Evaluation will occur; demonstrate that you know what might be needed in order to get the corrective procedure (or surgery if that is what is needed).

My understanding is that they will be doing a flow evaluation at the appointment I have. I think this is the one where you wee down a funnel and they measure the flow rate. I'll have to wait and see what happens.

 

[Proud to be erratic]

My understanding is that they will be doing a flow evaluation at the appointment I have. I think this is the one where you wee down a funnel and they measure the flow rate. I'll have to wait and see what happens.

In S Bucks, that's done by a nurse (along with a prostate check) and while it is useful to some extent the Dynamic Flow Evaluation needs a Consultant to actually do the installation of the Piezometers (the pressure reading sensors) and to interpret the resultant graphs, at the time. Presumably, if there was a contradiction within the graphs the expert is there and able to repeat or take other readings. I asked the Consultant about this, thinking it seemed well within the tech capability of a SpecialistvNurse and he replied something to the effect of No; but he also was happy to be doing the tests himself if he was subsequently going to do the prostatectomy. This seemed logical at the time.

If you know the name of the Consultant whose Clinic that you are attending you can probably phone his Secretary and ask exactly what will happen during your May appointment. Nothing like being closely involved in YOUR consults and treatments to show you want and need this sorting out.

 

[everydayupsanddowns]

Welcome back @Carlos !

Nice to see you posting agan.

Hope the checks on flow rate and prostate provide helpful information and/or reassurance.