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Patients speak about prostate cancer and laparoscopic radical prostatectomy

Steven Guillemette, Winter Springs, Florida

I felt like my foot was stuck in a railroad track and I could see the train coming.

My father was diagnosed with prostate cancer about five years ago. I then heard that three of my uncles had been diagnosed with prostate cancer. Three years ago, my 52-year old brother was diagnosed. This year it was my 59-year old brother.

My thoughts about prostate cancer were dominated by the experience of one brother's open radical prostatectomy. It was a horror story. He suffered so much pain, and three years later still suffers from incontinence and erectile dysfunction. I tried to put this out of my mind, but it haunted me each time I had a PSA test. My PSA had been up and down for a couple of years, and biopsies came back negative.

I was 53 years old when, In August 2003, my PSA increased from 5 to 6.1 ng/ml and it was time for another biopsy. On September 19, 2003, the train hit. My urologist called to say that one of the biopsy samples came back positive for cancer. I was told that it was a very small spot and that it was contained within the prostate.

The urologist went on to explain the different treatment options: hormone, external radiation, internal seeding, watch and wait, and surgery. He proceeded to tell me a prostatectomy involved making a 6" to 8" incision down the abdomen and that I would need to donate two units of blood, which could be used for a transfusion. He said that his patients usually lose 400ccs of blood. I was not interested in any of these options. My 59-year old brother had had an LRP surgery done in July 2003. When I asked my urologist about LRP, he said that it was a fairly new procedure and that only a few who did this procedure. He didn't know anyone who was doing it.

I immediately called my brother, who informed me that he had learned of LRP "through the grapevine," through a partner's sister. I felt blessed to be a part of this grapevine! This feeling turned to excitement when I read more about LRP and Dr. Krongrad's expertise. I was even more excited to learn that he is only four hours away from me. Then, I could hardly believe my good fortune that he is on my insurance plan.

I e-mailed Dr. Krongrad on Sept. 21st at around 8:30 p.m. Before going to bed at 10:00 p.m. I decided to check my e-mail. Dr. Krongrad had already answered my e-mail with details about contacting Ruth for an appointment! My wife called Ruth the next day and set up an appointment for Thursday, October 2nd - only a week and a half later! I knew this was where I was having my LRP.

My wife and I drove to Miami on Wednesday night for our Thursday 2:30 appointment. This gave us time to check out accommodations for after the surgery. When we arrived at Dr. Krongrad's office we found a relaxed atmosphere. Ruth and Hope were most pleasant and helpful. When we met Dr. Krongrad, he made us feel more like a friend than a patient. Dr. Krongrad checked me out and spent a long time talking with me. I didn't have a lot of questions as I had read through Dr. Krongrad's website and some of the patient stories. Ruth scheduled my surgery for November 14, 2003.

The next six weeks were too busy to even think about the upcoming surgery. There were trips to the doctor's office for surgical clearance, x-rays, blood work and transferring records. At work I needed to find out about insurance details and taking time off. As a caregiver to my parents, I tried to make sure they were situated. But as it turned out, my mother went into the hospital with chest pains and spent the week in the hospital. Mid-way through that same week my father, who suffers from Parkinson's disease, took a fall and spent the night in the same hospital as my mother. Dr. Krongrad advised me to "get some rest" the week before surgery. My parents were OK, but I was WIPED OUT!

On Wednesday, Nov.12th, I drove to Miami with my wife Gail. We got settled in at the Monaco Oceanfront Resort in Sunny Isles. Nov.13th we went to North Shore Medical Center to pre-register. Clear liquid fasting starts today. Oh yeah, and the fleet-prep cocktail is today. I was glad to have a room with an ocean view, because I definitely wasn't going anywhere!

Thursday, Nov. 14th at 5:15 A.M. came too soon. We got up and headed to the hospital. I went up to get "prepped." I was given the nice little gown with no back. Then came the clippers. They shaved me from the middle of the chest down to my left knee. I looked like a poodle with a really bad haircut! But the staff at North Shore is wonderful. They started an I V and I never felt a thing. My wife came in about this time. The anesthesiologist asked me some questions and filled me in on what he would be doing. When Dr. Krongrad came in I heard an announcement over the PA system: "Dr. Krongrad is in the building!"

I was in surgery and recovery for approximately 5 hours. Afterwards, I didn't feel any pain, just like sleeping. As the anesthesia wore off, I felt a dull ache in my abdomen. I took a couple of Tylenol. At 6:30 I got up to walk, but became got dizzy and nauseated. Dr. Krongrad said that it was probably the anesthesia. Sleep it off and take a walk in the morning. The Dr. Krongrad said that surgery went well and that I only lost 20 ccs of blood! (fyi - in traditional surgery blood loss is often more than a liter!)

Saturday, Nov 15th at 7 AM I am up and walking. I ate some Jell-O and broth then went for another walk. Dr. Krongrad came in, removed the drain, and checked my incisions. He removed my IV and we went for a walk down the hall and chatted along the way. He said that I was doing well and discharged me at 1 pm (26 hours post op!).

I went back to the motel with my wife. We had a 2nd floor room so I had to climb a flight of stairs. I took a shower and shaved. Now I felt like $55,850.00 (that's a million bucks after taxes). Then I took a nap.

The motel has a continuous balcony around the entire 2nd floor. The weather was nice so I was wearing short pants. I found that I could put the Foley bag in a plastic grocery bag while I walked. The Foley bag was not noticeable and the catheter came out of the shorts at the knee and into the grocery bag. So this was my routine - walk, eat and sleep.

Sunday Nov16th. Dr Krongrad called me at the motel to see how I was doing. He asked me again "have you farted?" (What a great guy!). After you pass gas you can have solid food.

Monday, Nov.17th .I took a ride to Dr. Krongrad's where he checked my incisions and removed the band aids. He said that I was healing nicely. I am feeling much better.

Tuesday and Wednesday. We took in some sights around Miami and Key Biscayne and spent some time on the beach. I wore shorts on the beach, so I just folded the Foley bag up so it didn't hang out.

Thursday it was time for our four-hour drive home. We stopped at Butterfly World in Pompano. We spent four hours walking around there then continued our drive home.

Nov. 24th. The big day arrived to have the catheter removed. I went to my urologist in Orlando. I showed him my "party favor LRP photos" from Dr. Krongrad. He said that LRP is the way of the future and he would be interested in learning LRP.

The catheter slipped out without pain. I was expecting a big gusher or urine but it didn't happen. I wore a pad each day but would throw it away dry at the end of the day. I have had no problem with incontinence, just a drip or two on a few occasions. Six weeks post-op, I still have a bit of perineal tenderness but that's about gone.

I want to thank Dr. Krongrad and his staff. They have made me a survivor, and they'll help you become one, too!
Steven Guillemette - Florida