I figured I'd write a short account of my first experience with robotic surgery, in case someone considering the same will find it useful.
I hadn't had major surgery before, so everything was new to me, and I had very little idea what to expect. The surgeon's office provided a document to prepare me, but it was misleading and of limited coverage.
ANESTHESIA: Once the nurse had shaved off all chest and pubic hair, and inserted the IV, I met the anesthesiologist, who was quite nice. I was nervous about going under, but I needn't have been. They essentially tricked me my telling me to prepare for moving to a cold table. I put my mind on that problem, and before my gurney had turned the second corner on the way to surgery, I was out.
WAKING UP: I woke up in the recovery room, and got my first cup of ice. That ice would be a mainstay for the next 24 hours to help with a dry mouth. Once I was stable, they moved me to my room and I went to sleep. I was on extra-strength Cipro (antibiotic) and morphine.
PAIN: The incision and even my pelvic area had little pain, but two other places posed bigger problems. First, I started having abdominal spasms if I moved unexpectedly. Suddenly, my abdomen would flex like a big cramp, and it would take a while to settle down. These occurred occasionally for the first twelve hours. Fortunately, they did not do any damage; they just hurt. The big surprise was my shoulders. I found the pain in my shoulder joints excruciating if the pain killers wore off. I learned later that this is a common ailment from surgery, having something to do with the positions they put you in and the hard, cold table you rest on. In my panic I was sure this was tendon breakdown caused by Cipro or signs of metastasized PCa.
This pain continued for days, but it was worst the first 24 hours.
FOOD: By the next day, they started serving soft foods like ice cream and jello. Very nice to have something solid. Already I was starting to think this bowel movement thing might not be so bad. I was wrong, of course.
: The day after the surgery, they need to get you up walking about (with the catheter) to make sure you can check out by the afternoon. At first I didn't believe it would be possible, but I was able to hobble about with some discomfort. I made extra effort to walk around, as I didn't want to hang around the hospital any longer than necessary.
MEDS: I was discharged with prescriptions for Cipro and Percoset. At the hospital, they had started Percoset instead of morphine after about 18 hours. A couple of hours later I started to itch. I asked the nurse, who said it was probably the cleaning residue in the bedding and gown. NOT! Ten percent of us respond to Percoset with itching. We were given the fact sheets for both meds, which scared the crap out of us. So much so that I did not take the Cipro, and I had to discontinue the Percoset. I went to extra-strength Tylenol, which was just barely adequate at best. Other narcotic-based pain killers cause constipation, and aspirin/ibuprofen interfere with healing.
HOME: I went home and slept in easy chairs or the couch, learning how to use the urine bags. We got on a schedule for meds, and recorded the ins and outs, so to speak.
BOWELS: I hoped to resume normal bowel activities quickly and was bit impatient. I perhaps rushed a bit in eating normal foods. The surgery literature advised stool softeners (good), but also mentioned that a light dose of Milk of Magnesia could be used. So four days after surgery, I tried the lowest dose of the Milk, and had a violent bowel reaction that slammed my pelvic floor. Oh that I would have been patient. This brought a freshet of blood in the urine, and my testicles and penis turned dark purple from the internal bleeding. This didn't require a doctor visit, but it added to the pain in sitting down. In fact, it took two weeks from surgery to have my first natural bowel movement, with the help of stool softeners.
BLADDER SPASMS: I had the catheter out after a week, and all seemed great for about a day. Then I started having bladder spasms that were quite painful, with burning urination. After four very uncomfortable days with just the tylenol, I finally had to go to the emergency room and have the catheter re-inserted (6 hours!). Ahhh... After another week, and a leak test, they removed the catheter again. Then started the diapers and pads for the next four weeks until things stabilized. While I thought the spasms may have been because the Milk of Magnesia fiasco, the doc said it just happens to some guys.
UROLOGIST POST-OP VISIT: Face time with the surgeon(s) is very limited. I met with a colleague for a couple minutes the day after the surgery, but then just a couple of emergency phone calls and finally my scheduled post-op visit. This just happened to coincide with my second catheter check. He did the bare minimum to get me out of the office, disappearing whenever he could delegate to a nurse. I had to get him to come back to answer a question. You get the feeling you're in a giant surgery mill that doesn't care about patients very much.
SITTING UP STRAIGHT: After 3.5 weeks or so, I was feeling much better and started sitting up for a few hours, often in front of a computer. Just after the surgery, I occasionally saw blood in my urine, but that had pretty much gone away. But sitting up caused a new kind of pressure on my surgery, and my initial spurt of urine had quite a bit of blood, scaring me. I was expected back to work in 10 days, and the pain of sitting and the blood made me wonder if it was possible. I called the urologists office with my question and they never returned the call.
In the end, the bleeding and most of the soreness ended the day before I had to return to work.
Now, six weeks after the surgery, I'm much better. I expect to get back on my bike this weekend. I spent last weekend at a friend's cabin, riding in a car four hours each way without discomfort.
And through it all, my wife was an angel.