It doesn’t matter how fit you are, how well you look after yourself and how positively you view life, sometimes stuff just happens to you. When it does you can’t ignore it. It won’t just go away as I found to my own cost.
So I thought I would share my story of what has become affectionately known this year as “Pete’s Problem”. Here goes:
It creeps up on you over time and because its so personal and invisible its something that tends to get ignored. Oh and blokes don’t like to talk about such things either. We might take the piss in the pub about the one in the gang who has to keep going to the loo but its perceived as weakness or a sign of failing masculinity to not be able to hold your beer and control your bladder. So playful mockery is a legitimate bloke reaction and seldom do we stop to ask if they are ok or try to help them to face the truth that there is an issue that shouldn’t be ignored. As I’ve found out to my cost, prostate problems don’t go away on their own.
During the day it tends to be ok. You can normally nip to the loo whenever you need and occasionally things can get critical when there doesn’t seem to be a loo when you need one. But its at night that things start to change. At first you are getting up half way through the night to answer the call of nature and slowly but surely you can find yourself getting up every hour. This is when it really has an impact (even though you don’t realize it) as a full nights sleep becomes a thing of the past. Strangely though your body adjusts to being permanently tired and a part of your brain kicks in to tell you that everything is ok.
Little by little we accept the new normal and we ignore the fact that this new normal isn’t ok.
Then something dramatic happens that changes everything.
For me that dramatic event happened last December when I was meeting up with a few old mates in a pub in London. It was busy, it was great to see them again, we had lots to catch up on and it wasn’t easy or convenient to keep nipping to the loo (and I probably also didn’t want to run the risk of being the butt of the weak bladder jokes). When I did go I found something unusual happened. I couldn’t go at first and then it only came out in a dribble. This was not good. Each time I attempted to leave the loo I knew I needed to go again but thankfully with multiple repeats I emptied my bladder. Shortly after it was time to get the train back up north to Chester and I was now unable to urinate at all even though I was desperate. It felt like I was having contractions for the whole two hour journey. It was so painful. Somehow I got home and my wife suggested a hot bath would ease things and also that I should drink more water to try and flush out whatever was causing the problem. We had no idea that this was the worst thing we could have done at this moment!
We were ignorant about urine retention which is a condition that is caused by the bladder going into spasm and therefore preventing any fluid from leaving the bladder. The only way to deal with it is to have a catheter inserted to drain the bladder and then leave it in there for multiple days to allow the bladder to recover from the trauma. As my contractions got more frequent and more intense we ended up in A&E where I was rushed to the front of the queue to have the catheter procedure which thankfully, brought instant relief.
My prostate was seen as the cause of the problem as an internal inspection suggested that it was large but smooth and therefore probably benign. I was prescribed a drug called tamsulosin to relax the prostate and bladder to minimize the risk of going back into retention. I was told that I’d now need to take this drug indefinitely and whilst this news depressed me at first,as I do not like to feel that my body needs to rely on drugs to function effectively, once I adjusted my way of thinking I realised that it was a simply a tiny daily inconvenience to prevent further significant breakdowns. Over the next few months I had various other tests to check my flow rate and capacity to empty my bladder and whilst I didn’t score perfectly I was seen to be well within the acceptable range and so I continued to take the medication every day and settled into a new normal.
I got back into training hard, the early part of the race season began well and I put the retention episode behind me.
But then it happened again, only this time in the middle of a race.
I was in Sweden competing in my 1st Ironman 70.3 Triathlon and unknowingly went back into retention during the bike leg. I went from feeling that I could soon do with a loo visit to the dark realization that it was too late and I had now tipped over the edge into retention in such a short space of time. Having suffered retention once before I knew deep down what I was facing, but just couldn’t bring myself to confront it during the race and so decided to complete the run in the bizzare hope that my body would miraculously resolve it. I stopped at every aid station over the half marathon distance to try and urinate to relieve my growing discomfort levels. It was futile as I was already in retention. Eventually I crossed the finish line in agony, was put straight into an ambulance and rushed to the local hospital. To the shock of the medical team more than 3 litres of fluid was drained from me ( a normal full bladder is approximately one litre) and so lots of blood tests were quickly carried out. Thankfully, everything came back clear and so I was allowed to return to UK the next day.
It was now clear to me that my medication was not working sufficiently well to prevent further episodes of retention. I found a new Urology Consultant and embarked on 3 months of intensive investigations to try and understand what was happening and why. I was given additional medication whilst we continued our investigations, the new drug being one that helps to reduce the size of the prostate over time. But when I learnt that my prostate was “super sized” it did seem that even if these drugs could reduce it over time I would still be left with a monster that could cause retention at any moment of stress. After viewing things as a result of an endoscopy, my Consultant concluded that I was continuously on the edge of going into retention and so we made a decision to have surgery to significantly reduce the size of my prostate. However there was another complication. Increasingly high scores from repeated PSA tests together with some suspicious images from an MRI scan led to a recommendation to have series of biopsy’s taken before making a final decision about surgery.
The risk of cancer seemed to be growing with every test I was having and yet I was still totally confident that my prostate was benign. It was only as I was arriving at the hospital for the biopsy operation that it dawned on me that I could have cancer. I did my best to put this thought to the back of my mind, but have to admit that I was suddenly very scared and the next 5 days before I got the results back were pretty difficult. Thankfully all 30 biopsies were clear and I have to say that I have never been so relieved in my life to hear this news. I was now able to proceed with the operation to reduce the prostate.
A few weeks later I went back under anaesthestic and had 50 grams of tissue removed. 24 hours later I was allowed home and delighted to be catheter-less and no longer requiring any of the previous medication. The next three weeks were difficult and uncomfortable as the body was beginning to heal but slowly things started to settle down. At first, urinating was very painful, far too frequent, often blood stained and triggered intense nerve pains all down the backs of my legs, but as the healing progressed these symptoms eased. One month on, I now feel as though my bladder is much more relaxed, the nerves around my whole core area have recovered and I’m sleeping so much better than I can remember for years. My brain has taken a while to adjust to not needing to wake frequently through the night but I’m now enjoying unbroken sleep which feels like such a treat.
I’ve now had my post op flow tests which are showing that I’m able to fully empty my bladder again and am urinating like an Olympian! The decision to have surgery was absolutely the right thing for me to do and I’m hopeful that this will have incremental performance benefits for me next year (as well as obviously eradicating the danger of further retention).
My Consultant has given me the green light to begin some very light exercise and you won’t be surprised to learn that I have taken him at his word. I have loved getting out for a gentle jog, raising my heart rate a bit and sensing the blood pumping around the body again. I should be fully healed and ready to resume proper training on December 1st. 2017 is going to be a great year.
So why am I sharing all this personal stuff that some might find awkward or embarrassing ? Well, its simply to help you to avoid what I’ve been through or worse, given that Prostate Cancer is the most common cancer in men and one in eight of us will get it in their lifetime. I know that I am lucky that my prostate is benign.
If you are experiencing any problems urinating whether that’s to do with reduced flow, increased frequency, sudden urges then don’t be shy or embarrassed and don’t ignore it as it will only get progressively worse. Go and see your GP and get checked out. The earlier you do it, the better chance you’ve got of avoiding what I’ve been through and I can categorically confirm that you do not want to experience this if you can possibly help it.