Sunday, October 31, 2010

Journey to Health: Eight Weeks Post Surgery

Entry for 31 October 2010:

It has now been 8 weeks since my surgery. I have spent that time off work, on medical leave, getting lots of sleep, spending an increasing amount of time on pelvic floor muscle (“Kegel”) exercises, walking 30 – 45 min/day, reading, doing email, writing & beginning to do phone consultations with my research students. It has been a time of healing, rest, recovery, but also frustration as I have had to deal with post-surgical complications (urinary incontinence) that were worse than I had anticipated (hence the exercises).

When the biopsy results came in, they indicated that the cancer was more advanced than anticipated (T1c => T2c), but that they had got it all (the prostate margins were clear of cancer). It’s a very good thing that I didn’t wait any longer to have the surgery!

I did a bunch of reading to try to understand what was happening to me, and what I learned struck me as deeply ironic and darkly humorous: While women have only one urinary sphincter, controlled by the pelvic floor muscles, men have three: one between the urethra and the bladder, the prostate itself, and the external sphincter, which is the same one women have. This is why women have more trouble with incontinence generally than men, and especially after giving birth vaginally, and why most women are familiar with Kegel exercises. I had apparently been relying heavily on my other two urinary sphincters, which now had been removed surgically along with my cancer and associated replumbing. This put me on an even footing with all the women in the world, including my new granddaughter Mizuki! There appears to me to be some sort of poetic justice to this. And while the adult women I know clearly now have a headstart on me, I am pretty much in the same camp as my granddaughter, trying to learn how to use a part of me that I wasn’t even sure I could sense, let alone control. I feel like I now have a new body, which I have to learn how to use.

From my research I learned that I was likely to have to practice these exercises for as long as six weeks before I would even begin to see any effect. I would have to do them on a sort of blind faith; I would have no basis for judging my trajectory of recovery. The research I read indicated that a systematic program of exercises of at least 6 weeks was likely to produce substantial positive results; however, I had no way of knowing if those average results would apply to me. To tell the truth, I found the whole situation scary, embarrassing, infuriating, and as I said ironic and darkly humorous.

I’ve now been doing my Kegel exercises for 5 weeks now, and am starting to see some results, but it’s slow, incremental progress. Over time, they’ve become a kind of prayer, for myself and friends who are going through a hard time.

All through this period, I gradually increased how much work I could do, to the point where I was easily doing 4 or 5 hours of email, writing and phone consultation a day. I managed to work my way through the enormous backlog of emails dating back to last January. I wrote a challenging book chapter on negative therapist reactions.

Last week, after having had my medical leave extended to near the end of October, I met with both my GP and the University’s occupational health physician. They both agreed with my assessment that although I am not currently able to work full time, I am fit enough to go back to work on a part time basis, on a “phased return to work”. The plan is for this process to continue for the next 6 weeks, between now and the Christmas holidays, with me gradually increasing the amount of work I’m able to do. This makes eminent good sense to me, although it is requiring some renegotiation of commitments for that time period. Tomorrow (Monday) I give my first lecture in months!

In the end, as much of a nuisance as the incontinence is, it is infinitely preferable to having a cancer that I now know was far more dangerous than I realized at the time. I am enormously grateful to have that burden removed and equally so for this time of rest and healing, which I so badly needed. This is clearly a much more healthy way of life. I am also deeply grateful to all those who brought by gifts (some quite creative) and cards or who sent positive thoughts, prayers, and wishes my way. Although I have spent most of the past 8 weeks in my flat, I haven't felt lonely with all of this caring around me. Thanks!

My current challenge continues to be, as one of my friends recently wrote to me, “master of my flow”. But after that, the even bigger challenge will be learning how to master the flow of my life so that it is no longer overwhelming and harmful. It is now clear to me that this will be a matter vital for the health of both my body and my soul.

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