Anyone with a copy of Lou Reed’s classic (my opinion) 1972 album, Transformer, should flip it over and remind themselves of the artwork on the reverse of the album/CD cover. For those whose music collection is sadly lacking, I’ve pinched a JPEG of it and included it here. Click on it to see a larger image. I draw your attention to “Mr. Poser” in the blue jeans on the right: his jeans look as though they contain about 10ins/25cms of garden hose strategically positioned and clearly designed to impress his target audience, whatever that might have been. Given Lou Reed’s proclivities in the 70s, I’m not sure we really know who his intended audience was. Come to that, I’m not sure Lou Reed in the 70s knew his target audience – absolutely anyone, I suspect.

Good old smutty schoolboy humour, which, of course, I gave up many years ago [Ed: AHEM!], remind me of another similar attraction tactic. Try stuffing a pair of rugby socks into your underpants to impress the girls. [Chortle, chortle.]

I wouldn’t describe my current, hopefully temporary, requirement for continence pads following my prostatectomy to be an advantage, exactly, but the pads certainly obviate any need to enhance my appearance using the old rugby sock ruse. My initial pads were so large, more like adult nappies (diapers, in Amerispeak), that nobody would have been fooled. Those in my emergency supply from our local incontinence service, though, were a little more subtle and may have deceived the unwary, given sufficient vodka.

Why had I had to secure an “emergency” supply of pads from our local incontinence service? I’m glad you asked.

Four weeks ago, at the end of my long day of trial without catheter, I was sent home with a discrete carrier bag containing 15 v. large, subtle-as-a-sledge-hammer pads. Given my usage at the hospital, this initial supply represented only about 5-7 days supply. The urology nurse explained that she’d arranged to have 3 months supply delivered to our house.

After five days, no supplies had been delivered so I phoned and explained my dilemma; leaking like a sieve, pads running out. My helpful nurse re-placed the order for me but we were now approaching the Christmas period when a) people take time off work, and b) deliveries get disrupted by volume, anyway. I was not hopeful. She suggested I try our GP surgery.

I contacted my GP surgery (#1) who passed me on to a local NHS clinic (#2) who had pads available but, because they needed authorization to dispense them, passed me on to the local Bedfordshire incontinence service (#3). Hot potato! #3 incidentally, has its phone manned only four hours a day, two hours in the morning and two in the afternoon. I waited for my afternoon window of opportunity and called. I explained my predicament and, despite not having any paperwork for me (I’m being treated by Bucks not Beds), the nice man at #3 took pity on me and compassionately authorized the release of an emergency supply of pads from #2, the local NHS clinic. What Carol collected was a pack of 42 level 4 pads, smaller and more comfortable than my originals though I was, at first, a little dubious about their capacity. Time had managed to reduce my usage rate, however, and I eventually felt assured that this new supply was likely to last about a month, plenty of time to see me through the holiday period when my urology nurse would be back at work.

Towards the end of said month, as predicted, the second order for my 3-month supply of pads proved to have been no more successful than the first order. Clearly, something in the supply chain solution, maybe the logistics, was broken. On Monday I phoned my urology nurse again and explained that my emergency supply of pads was now getting depleted. “What about other patients?” I enquired, “Is it just me or are they also having supply problems?” “You’re the first using this system”, I was told, “we wondered how this might work.” “It doesn’t”, I replied. Nursey told me she’d bring some to our approaching Friday progress meeting but would place the order for a third time anyway.

On Thursday, Carol answered the door to a UPS delivery driver who presented her with three cartons discretely wrapped in plain black plastic. Carol was confused and wondered what this delivery might be. The packages were not heavy. “I suspect these are my long awaited pads”, I said. Sure enough, a few swift slashes [Ed: interesting choice of word, given the situation] with a penknife revealed 17 packets each containing 20 level 2 pads. 340 of them! The delivery note confirmed that these were expected to last three months. These were a yet lower-capacity pad but a quick calculation made me realizing that I had been allowed four a day. Having been a little fretful until my supplies were secured, I could finally relax and not worry about over-usage. I should feel able to tackle more exercise/tasks.

Being smaller again, the pads in this main supply are more comfortable. They are shaped more like a padded cricketer’s box. These really are shaped to assist any posing I happen to feel like doing. Of course, regardless of the disappointment anyone deceived might ultimately feel when reality eventually reared its unwelcome head, there really isn’t any point my emulating “Mr. Poser” on Lou Reed’s album up there given that I no longer have a prostate with which to capitalize on my catch. 😀

It is now three weeks since the removal of my accursed catheter so it’s way beyond time for a progress report. Blame the hiatus of Christmas which was, most unusually, a white Christmas in the UK. Cue Bing Crosby … [Ed: Worry not, I haven’t attached a sound file to anything.] Actually, as inconvenient as the white, slippery stuff may be, I much prefer cold, crisp, clear blue skies above dazzling snow to our more usual damp, grey, muddy, drab nothingness. But I digress, this was not intended as a weather report. I need to return to mid-December …

Throughout this radical prostatectomy process, I’d been made aware that I’d suffer a period of incontinence following the operation and catheter removal. In my mind, I connected the term “incontinence” with what I’d heard about ladies suffering after childbirth and, reasonably frequently, in later life. That is, I had been thinking, “a leak when I sneeze, cough, laugh, etc.” I now know that such symptoms are referred to as stress incontinence.

The “trial without catheter” day at the hospital fixed that impression but quickly. Once upright, I was leaking, be it taking a step or just standing there. Having anything remaining in my bladder on the way to the facilities seemed to be merely a function of original content, rate of leaking, distance to said facilities and speed of walking with various muscles clenched. I’ll leave it to the reader to come up with a mathematical formula. I couldn’t even stop my leak to get on the facilities. This, I believe, is what is called total incontinence due to loss of sphincter control. Fortunately things were OK sitting down. I suspect this was simply due to the physical arrangement of my relevant anatomical components – bladder below urethra would be my guess. After saturating no less than three large pads during my seven hours at the hospital, this is how Carol, bless her, drove me home.

At home, I could do little more than sit as still as possible moving only when necessary to leak my way the 30ft or so to our loo. Due to the leaking as I prepared to use the loo, I was fretting about carpets, etc. We started improvising pedestal mats as some form of protection. A little earlier in the year we’d taken delivery of two new leather sofas which Mr. Leaky was now having to spend all his time sitting on. Just in case, I covered my chosen seat with a towel.

Eventually the clock ticked round to bedtime. After our stressful day, it didn’t have to tick very far, either. I’d elected to use our second bedroom to avoid disturbing poor Carol with who-knew-what lying ahead. Still wearing underwear to hold my pad in place, I climbed nervously into bed. I read a while but, actually, as I lay there, I realized I was scared almost witless of going to sleep. With all this leaking every time I stood up, what on earth was going to happen when I fell asleep? I don’t usually sleep on my back, though I’d had to in hospital for the three days following my operation courtesy of all the tubes pinning me down. Could I lie on my side safely? I tend to toss and turn a lot; could I turn over without leaking? Was I going to leak almost constantly and would my fresh pad last through the night?

Now I was convinced I’d be ruining the mattress. I was never going to sleep like this. My mind was racing trying to think of ways to protect the mattress. All I could come up with was a pack-away waterproof jacket designed for hiking. At about 1:00 AM, I went in search of my waterproof, unfolded it and spread it out over the mattress beneath the bottom sheet in what I estimated to be the most suitable position.

I felt a little more relaxed. The night was still an unknown quantity but I’d done all I could. Eventually I slept. I awoke at 4:00 AM in need of the loo. No accidents so far. I slept fitfully for another couple of hours when Carol-the-carer arrived with tea. I’d made it through the first night and so had the bed. Phew!

My mother, bless her too (she’s 92 going on 93), told us that she still had some pads specifically designed to go underneath sheets and protect mattresses in such situations. These dated from 43 years ago when she was looking after her own mother in her final year. It’s amazing what people hoard in their severely restricted living space. Nonetheless, I was very glad to put them to good use while I was getting accustomed to my latest medical difficulty.

One mattress protector went under my towel on the leather sofa, too. 😉

Yesterday was another milestone in my process to get fixed. We were due another fun trip to High Wycombe hospital for what was billed as my “trial without catheter”. From Catheter Catharsis, regular readers will be well aware of my feelings towards that infernal device and that I was very much looking forward to seeing the back of it. I was a little concerned about the word “trial” which seemed to imply that they could potentially find a reason to reinstall it. I didn’t want to consider that possibility.

Having had one race with the snow when I was admitted to the hospital for my operation two weeks ago, the weather again demonstrated its unerring sense of timing. Once more snow was forecast and we had the “can we, can’t we?” nervousness. As it turned out, Thursday morning remained clear and Carol dropped me at the hospital for my 8:00 AM appointment with the urology specialist nurse.

At 8:30 AM the nurse greeted me, told me to strip from the waist down and offered me her couch. There’s nothing like a medical process to conquer any remaining feelings of bashfulness. Now, given the discomfort I’d experienced when walking with the catheter, though I desperately wanted it out, I wasn’t looking forward to the actual process of it being removed. While she was deflating the internal balloon that secures such things in place, the nurse advised me to breathe in through my nose and out through my mouth. I was happy to comply with any advice offered by the experienced as she began pulling.

What a weird internal sensation! I think I expected discomfort, maybe even mild pain but no. What I got was a feeling that an Olympic class earthworm was sprinting it’s way to the outside world using my urethra as its tunnel. Or maybe this was the 8:30 train pulling out of Bladder Station and disappearing down the underground (subway, in Amerispeak) Urethra Line. Either way the weirdness was relatively short-lived and I was free of it. Phew!

My admission letter had warned me to expect to be there all day, hence Carol had returned to Aylesbury for some retail therapy with her mother and sister. There were two things on my potentially day-long agenda.

Now catheterless, I was dressed elegantly in my first absorbent pad (nappy/diaper) and given pen and paper with which to perform my my first agenda item: fluid accounting. I was to log my input and output of liquid. Every movement I made seemed to cause a leak which I could feel. I was ushered into the ward’s day room where I sat reading Sue Grafton’s Q for Quarry and drinking water (stick it on the form) until I felt the need to relieve myself. Very tentatively, I got up – squirt – bent down –squirt – to pick up my measuring bottle – squirt – and began marching to the loo; left – squirt, right – squirt, left – squirt, right – squirt. Oh good grief! They told me to expect incontinence but I wasn’t ready for this level of it. I leaked significantly doing anything other than sitting still. Even standing and not moving, I leaked. Miraculously, having leaked my way the 15m/45ft or so to the nearest loo, there was some left in my bladder: 200ml – stick it on the form. This routine continued through lunch.

My second and, perhaps, more important agenda item was to meet my surgeon again for the histology report. The surgeon is a busy chap. This being precisely two weeks since my operation, he was again in theatre performing another radical prostatectomy on another deserving soul. He had a meeting in the ward at 2:00 PM; maybe he’d get to see ne before that. No such luck. Finally, at 4:00 PM, my catheter-withdrawing nurse had trapped him and came to grab me. Squirt, squirt, squirt.

The histology report was as favourable as I could have hoped. My cancer had not increased in aggression; the Gleason score was still 7 (3+4 with an 80%–20% split). Crucially, all the extremities of my excised organ were clear and showed no sign of cancer cells. Thus, indications are that the cancer should have been entirely localized and completely contained within my prostate. If so, the operation should have got it all.

Time will tell. We have to wait three months for all existing PSA to be purged from my system then we begin a year of three-monthly tests.

Meanwhile, we have to learn to deal with my latest inconvenience [Ed: spot the pun?] of incontinence and hope that the situation improves as expected by the medical folks. Though basically more comfortable, I actually now feel more trapped than I did with the catheter. I console myself with the thoughts that this is early days and it’s something we have to endure if I’m to have a chance of getting beyond it to a complete fix.

Having had to wait so long for the histology report, the snow had arrived. My sterling chauffeuse went above and beyond to return to Wycombe and give me, now in my third nappy of the day, a safe and comfortable ride home through the flurrying flakes. Unbounded gratitude to her.