Sandra's My Partner's Urology-Prostate Saga

For much of October, while putting together Issue 188 of positivehealth.com, I have also been caring for my partner and webmaster Mike, recovering from a hernia repair operation. As everybody who has ever been in hospital and ever undergone any surgery will know, the euphemisms used by medical doctors to describe minor procedures never convey the dramatic and sometimes catastrophic reality experienced by the patient.

As someone who, as a child, nearly died of meningitis and spent a long period in hospital, and who has had various ‘minor’ operations during my childhood, youth and young adulthood, I am acutely aware of how what seems to be a non-major operation balloons into such feelings of vulnerability, pain, helplessness. Just the simple, normal functions of urination, defecation, walking, assume monumental mountains to climb on the journey back to health.

Today my partner told me that he understood why my mother, who nearly died of Clostridium difficile following knee replacement surgery in Montreal, absolutely refuses to have her other knee operated, despite being severely disabled. Mike, perfectly healthy, fit and strong, suffered an inguinal hernia about 6 months ago, probably self-inflicted during his intense stretching and exercising regimen. Although he was able to go about most of his ordinary life with the help of a hernia support belt, he wouldn’t have been able to resume exercising and exert himself unless the hernia was repaired. So he underwent the laparoscopic repair surgery on a day surgery basis and was discharged several hours later in the afternoon.

And that is one of the problems. When you are discharged from the day surgery, you are meant to refer any issues, problems, complications, etc either back to the GP, or go to Accident and Emergency. As someone who grew up in Canada where patients can visit any specialist doctor they choose, the limitations of the NHS system have loomed massively. All the complications ensuing from this hernia operation – urinary / prostate / kidney infection, pain, constipation resulting from pain killers with codeine and electrolyte disruption due to other medication for the constipation have all been typical drug-related issues. In fact, the infection – whatever it has been – almost certainly was iatrogenic, as Mike was perfectly healthy prior to the surgery and showed urinary problems immediately following the operation.

Having moved fairly recently to Kent and not having been able to assemble a team of holistically-oriented health professionals, I have suffered anguish regarding how to recognize and diagnose symptoms and attempt to move matters forward without heroic or aggressive interventions, which may have resulted from going to A&E on a Saturday or Sunday night. The GP hours are virtually 9-5; we have had more contact with the out-of-hours doctors, who are also generalists. What Mike needed and still needs is a doctor knowledgeable in urology. What he doesn’t need is to undergo further invasive interventions unless absolutely necessary.

I am sure that the scenario described above is familiar to virtually every family in the UK who has ever had the misfortune to have a family member fall sick or experience health problems. It appears that Mike has made progress, although he certainly doesn’t feel well, is still experiencing pain. He is finally undergoing blood, urine tests and will have an x-ray, but this has been arrived at through my virtually 24/7 campaign to email and phone the GP and out-of-hours agency. It is apparently a virtual state secret to discover or see the notes from the actual surgery. Quite incredible.

Hopefully by the time the Dec Issue 189 is published, Mike will feel better and this will be a nasty memory. My fingers are crossed, metaphorically speaking.

 

My Editorial from Nov Issue 188, detailing the somewhat harrowing clinical sequelae following ‘minor’ day surgery hernia repair of my partner Mike was written 25 October, just two days prior to Issue 189 being published live. At that juncture I was of the view that perhaps a corner had been turned. Little was I to know the drama which entailed subsequently.

On the very day, Thursday 27 Oct, that PH Online Issue 188 went live, an almost life-or-death scenario occurred, such as is sometimes portrayed in the movies when the actor is racing against time to reach a destination, or if you have ever run for your life at the airport to make it to your flight before it takes off.

I had a voicemail from my GP around 12.30pm to call him urgently - very unusual; despite my almost daily emailing and phoning the surgery regarding my partner Mike’s clinical symptoms I have never received a call from the doctor before. I had been out for some errand; when I returned the call, I was informed that the GP wasn’t there and he would be back at 4pm. When the GP did speak to me upon his return, it was to inform me that the results of Mike’s blood tests indicated that Mike was in kidney failure, that he had written a letter for me to collect and  to drive Mike to A&E straight away.

Mike had never even been in hospital prior to having his hernia repair day surgery; the 3-4 weeks since his discharge had been spent in pain, suffering infection, urinary difficulties with various doctors attending. Having always been healthy, the prospect of going to A&E had been the very thing Mike had wanted to avoid. We arrived at A&E; because the GP hadn’t contacted the Consultants there, Mike wasn’t on the ‘system’ and had to wait for several hours until being seen by the physicians on call.

Mike’s bladder was severely distended, due to kidney failure and urinary retention. There was no clinical option except to drain his bladder, insert a catheter and admit him for observation and to observe if his blood and electrolyte results returned to normal. [Incidentally, the foremost thing Mike had wanted to avoid during his month of urinary difficulties and pain was to be catheterised.] Mike spent the weekend in the Margate hospital, where there is no urology department or expertise; all urology for east Kent is in the Canterbury hospital. While Mike was in the ward, one of his granddaughters gave birth in the nearby maternity ward  to his first great grandchild, although he wasn’t able to visit her at the time. Incidentally, Canterbury has no maternity ward; this is all at Margate. This insane medical centralization mania has resulted in people having to travel many miles to get to the hospital with the services they require.

Mike returned home on Monday 31 October, his blood and electrolyte functions having returned to normal and has been recovering well, albeit still with catheter. We have both now genned up on urology, enlarged prostates and their propensity to cause problems following surgery, anaesthesia. He finally saw a urology consultant only today 29 Nov, who confirmed that it was his enlarged prostate which would have probably caused urinary problems at some point in the future (a urologist would say that). Mike will be scheduled to undergo a procedure (Trans Urethral Resection Prostate) TURP) to reduce his prostate. Hopefully I will be able to report the end of this saga in time for Editorial Issue 190. It always amazes how case studies with real people elucidate so many aspects of health as well as the healthcare bureaucracy.

 

Now, regarding my partner Mike’s medical urology, enlarged prostate saga. As of last issue’s publication date (1 Dec) we had learned from 3 consultants that the urinary problems which afflicted Mike following his hernia repair surgery had in all probability been caused by his enlarged prostate. Enlarged prostates affect the vast majority of men over aged 40-50 years of age; it is no surprise, therefore that Mike, aged 74 was also a sufferer. Just his bad luck to require a general anaesthetic for hernia repair surgery in the same general location in the body.

The urinary retention he suffered followed the hernia surgery, which led to acute kidney failure, his catheterisation and admission to hospital, also pointed to his best exit route from these problems – Transurethal Resection Prostate or TURP surgery to reduce the size of his enlarged prostate. Mike’s TURP surgery was 8 Dec and he was discharged from hospital 13 Dec, although still with a catheter. Before this can be removed, Mike has to pass some clinical hurdles to demonstrate that he can urinate such that his bladder does not retain urine. The next ‘test’ is scheduled for 30 Dec. Watch this space for further updates in Mike’s urinary tale.

I guess that one of the lessons I have learned again, which has been humbling, is that when it comes to health and medicine, it has become abundantly clear to me how much we think we know and how little we may actually know at the same time. No matter how much our own knowledge, it can never encompass the entire body of knowledge for every kind of condition.

And, in an analogous sense, it is a similar conundrum for my partner’s health and my quest to find advertising partners internationally – searching for like-minded individuals who really value the PH Online archive and who would like to run their businesses in helping to promote courses, practitioners, products and events in their respective countries. It has been tricky for me to seek out and locate people I don’t know - the proverbial needle in the haystack.

My sincere good wishes to all PH Online readers with the added message to keep fighting and campaigning to defeat the powerful forces who are strategically battling to remove our free access to high quality vitamins, minerals, herbs and natural supplements. Our voices and actions together can help to move mountains and achieve these very reasonable goals.

 

One good thing that has happened is that my partner Mike’s urinary enlarged prostate saga appears to have come to a happier outcome than I had been fearing. For those of you who have been following this mini-saga over the past 3 months or so, you may recall that as we were publishing the Jan Issue 190, Mike had returned from hospital, but still with a catheter. In order to lose this intrusive device he had to pass the urinary trial without catheter trial with the specialist nurse at the hospital. On 30 Dec, just a couple of days prior to 2012, he managed to pass the test, albeit with some reservations from the nurse. So he had to return a few weeks later to repeat this test, to ensure that he was emptying his bladder.

I am happy to announce that he passed this test again and has been discharged. The biopsy results on the prostate tissue removed were entirely benign; his condition has been improving and he is looking forward to being able to resume his exercises which caused his hernia in the first place.

I guess one of the lessons I have learned is that as we get older, the problems we encounter are ones with which we are not familiar. Long live TURP.