Photons on the Prostate - XVI

Sleep forsakes thee

It is probably time for an update regarding how I am recuperating following radiotherapy, I am up this early because I was up for most of the night, one side effect that I have not given much consideration is insomnia. I sleep to have to catch sleep whenever I can, but it messes up my day because I cannot concentrate fully on what I need to do.

For this, I should find the lifestyle adjustments that would help me sleep consistently and better in what are supposed to be the normal sleeping hours. I am careful about medically induced sleep, in fact, I have shunned offers of this kind of medication for over 15 years, especially when multiple medications then caused drowsiness, it all adds up and you want to wake up too.

Soon after radiotherapy, I also had Codeine prescribed as part of my pain management, as Codeine metabolises into Morphine, I was all too aware of the addictiveness and issues with withdrawal. I only used Codeine at night and just once a day. As soon as the pain and discomfort had eased, I began to wean myself off Codeine and I did it in a week.

Straining to pee

The bladder and urinary issues are much improved, I am on medication for benign prostate hyperplasia, basically prostate enlargement firstly due to cancer and the resulting inflammation after radiotherapy.

The urinary flow is better, checking with the IPSS Calculator, my IPSS score has fallen to 14, which is still moderate, but it is down from the 19 that was recorded just before I had the clinical consultation for the radiotherapy treatment option in late July. I must accept that these things take time.

I think Incomplete Emptying is not much of an issue, Frequency is moderate, Intermittency is low, Urgency is moderate, I have a Weak Stream, Straining is a feature of me being first as the urinals and the last to leave, I noticed that so many times in Cape Town, Nocturia is about thrice during the night, and I need an improvement in my urinary function.

The last question on the IPSS Calculator – “If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?” Before I commenced treatment, I was Mostly Satisfied, the feeling now is Mixed, I might need an appointment with Urology to talk through these issues.

As I am running the IPSS Calculator under medication for easing prostate stress on my bladder and urinary tract, I would think without medication, the situation is much worse.

Recuperating in Cape Town

Indeed, at this time of the year, any visit to Cape Town would seem like a holiday. This visit was anything but a holiday, it was the most convenient place for Brian and I to meet, so he could support my recuperation, for I had neither the personal nor domestic care I needed at home, as the side effects of radiotherapy worsened.

It did us a world of good, a lot of rest, the summer weather, walks on the beach, cooked meals, and much loving care and attention. We ventured a couple of social events but none of the typical Capetonian holiday stuff like venturing out to wine estates or tourist traps.

I drink cranberry juice, hardly any carbonated drinks, I have eschewed alcohol, I probably have had three glasses of wine in three months and for tea, I have stuck to decaffeinated tea rather than decaffeinated coffee until I am happier with the urinary situation.

Singing for the crows

One lasting side effect is my voice, it sometimes gains strength and timbre, but I do not know if I would totally regain my original voice, or it would settle somewhere near what it was. It sounds tired and slightly feminine, there might be some underlying fatigue to it brought on by insomnia too, possibly a topic for discussion at my next medical appointment.

In all, I can report there is considerable progress, I do tire easily, but I also will myself to do things and find the capacity to get things done. That is a good update.

Reference

MedScape: International Prostate Symptom Score (IPSS) Calculator