Sunday, February 24, 2008

Penile implant 4 weeks after surgery

Well, it's been 4 weeks now. No new pics because nothing new to show you, really. The swelling is down considerably in both my scrotum and abdomen. Things are healing more and hurting less. I had been taking ibuprofen, but don't have the need even for that the last few days. I mean, it's still tender, and I'm certainly aware that something happened, you might say, but it's not painful.

This week we do back to the doc to test "pumping it up". We're excited about that. With the swelling down, I can feel the pump a lot better now, though I'm still a bit uncertain as to just what I'm feeling. I've been trying to move move it too, as my doc wants, but I don't think I've accomplished much. We'll see this week.

The big event was having an orgasm! Wow! With my wonderful wife's help, though oral stimulation, I had my first orgasm in about 5 weeks (the last being a couple of days before the surgery) yesterday and it was great! It took a little longer than usual to climax, and it wasn't without a little discomfort, but it was, I repeat, great! The physical need and relief aside (which was considerable) I also needed to see things work. And it was great!

More later...

Wednesday, February 20, 2008

another blog to check out

I came across this after I had set mine up. Good stories and some pics

Monday, February 18, 2008

post surgery

After the Penile Implant Surgery

That night, and for the next couple of days, I was in some significant pain, but certainly not excruciating or anything like that. I just laid on the sofa, with my legs apart, played some video games and watched tv.

The doc have given me two pain killers, one very strong (oxycodone) and one less so (hydrocodone). I took the stronger one for only about the first 36 hours. I was not in all that much pain, and it made me feel so groggy and ill that it just wasn’t worth it. I switched to the other, which worked fine. I quit taken them altogether about 5 days after surgery with no regrets. There was still pain, to be sure, but not enough to make the general sleepiness and feeling of lethargy from the painkillers worth it for me.

There were problems, mind you. It was hard to pee the first couple of days just because of the swelling. That got better along about Wednesday or Thursday (the surgery was Friday, January 25th). And, I could not poop for about 5 days. That really became a drag because my stomach hurt and I was afraid to eat much. I tried (with the doc’s advice) a couple of over the counter stool softeners. Don’t know if that did the trick or if it just happened on it’s own, but things got back to normal about mid week.

I also had just a tiny bit of seepage from the incisions (I mean a few drops, nothing of consequence) in the first 5 or 6 days, then nothing at all.

So, one of my big worries with this (it’s gonna hurt a lot for a long time) was unfounded. I was actually working from home (my job makes that pretty easy) most of the week, and by Thursday was working almost all day. Reclined using my laptop. Sitting was uncomfortable, as you might imagine. But I didn’t really have to sit up much.

Another worry, being honest, has been regarding the "no sex for 6 weeks" rule. I doubt I've gone a week without an orgasm, from one means or another, since I was 13. Would this drive me crazy? Well, I have to say I've had zero desire the first 3 weeks. I am now just starting to feel a little bit of "stirring". We'll see how it goes.

During this time, my wife told me that the doc had chatted with her after surgery and said that he was very pleased with the size of the erection after the implant. He said it was 22 cm (I think). Not sure what that means to me yet. I accepted as part of this that I might lose some size. That’s ok, given that the alternative is a non-working penis. I have read and heard that the penis will actually get a little larger over time with the use of the implant, as things get “stretched out”. Since, by the time an implant is done, the penis is actually somewhat atrophied from lack of expansion, it makes sense. I hope so. I clearly have a noticeable increase in girth, even without an erection (full inflation). Truly, I am excited to see this thing..

We’ve had a couple of follow ups. At the first one, a week after surgery, the doc said everything looked good. He also deflated the penis a little. He left it slightly inflated initially to help the stretching and healing. When he did that, I have to say it was very very painful. He was squeezing both my very swollen scrotum and my sore penis. Jeez that hurt. It only lasted about 60 seconds, but it was a long 60 seconds.

We had a second follow up at 2 ½ weeks wherein we were supposed to fully inflate the thing. We were excited about that. Unfortunately, when we started to try that we discovered that it was still too sore. Disappointing. Had to reschedule for 2 weeks out. We also talked about the pump being too high in the scrotum. The doc has me trying to move it, but I have to be honest, even with his having shown me, I’m having trouble figuring out just what is what in there. The release valve is easy because it’s rectangular. But the inflation ball is a little tough to identify yet. Worst case is that he may need to open the scrotum up and move things a bit to allow for easy inflation. If that happens, he tells me it’s easy and nothing at all like the initial surgery. Meanwhile, I’m trying to push things around as best I can and totally trust that we will get this worked out in the end. I’ve come this far, I’m not going to worry about a possible minor setback.

So, that gets us up to date. The post op healing process has been very smooth. Now, 3 ½ weeks after surgery, I can still feel it, but it’s not at all bad and gets better every day. I’ve been working normally for the last two weeks. Walking and significant movement that bends my waist are a little uncomfortable, but not bad. Just noticeable.

A couple of things I would never have thought about:

I could not sleep on my side, which is my usual position, for the first several days. Not a big problem, but there it is..

Because the scrotum is swollen, it tends to stick and chafe a bit on the inner thighs. Baby powder solves that.

Because the penis does not “dangle” as it used to, when I pee sitting down, I have to be careful that the stream does not zip out under the seat. Sounds very silly, but it’s true for me…

I will update things in a week or so..

February 18, 2008

Here are some images. As I said, full frontal nudity, but intended to be informative not offensive. This is the kind of stuff I was trying to find when I was considering this procedure.

The whole surgical area 3 weeks after surgery


















The area of the incision for the tubes. Looks almost completely healed and "natural". Scrotom is still swollen and a bit purple. But should have seen it 3 weeks ago! Looked like an eggplant.


















Incision for the reservoir. Healing well, starting to look like a scar rather that a scab.



















You can see the scrotum is still pretty round from swelling.

















Short Video clip with comments.


Sunday, February 17, 2008

having it done

Preliminaries:

In order to make sure my insurance would cover the cost, my doctor worked with me on a pre-approval process. About 4 weeks before the surgery, he had me in for a blood flow test. This was pretty simple – he injected me with a small dose of Caverject to cause an erection, took ultrasound pictures of the penis and the area just under the penis, waited about 15 minutes, and took additional images. He said it clearly showed that my blood flow was good, very good even, but it was not being held in the penis. He showed me the images, which didn’t make too much sense to me, but I could see some of what he was talking about.

My doctor said what he saw suggested that a previous injury may have been the origin of the problem, which is the first time I every had someone say it’s other than a typical side effect of high blood pressure and diabetes. In some way, that makes me feel a bit better about the whole thing. It also makes a bit more sense with the fact that it’s been a problem to some extent for such a long time. I did have a crush injury to my scrotum and pelvic area years ago on a bike. I remember being bruised and sore for days. I wonder now if that was the root cause.

In any case, this step was simple and painless, except for the discomfort of the injection.

One thing that reminds me to mention, though. I have had to get used to lots of people looking at and touching my penis and scrotum. Kind of weird. For example, for this procedure my doc was assisted by a lovely young African American nurse from whom I now have no secrets. Not that people don’t try to give you as much privacy as the situation allows; they certainly do. The situation just don’t allow for very much.

So we got insurance approval without difficulty and went on.

About 10 days before surgery I had to go through pre-surgery testing at the hospital. It was the usual stuff – the 27th medical history, the next repeat of the same blood tests everyone does every chance they get and so on. I tell you, this has been a really eye opening experience so far as why we have a health care crisis going on. So much is simply repeated over and over again, and we pay for it every time. And, in this particular case, it really got stupid. One of the tests showed I had a low platelet count. That means I would be a high risk for bleeding excessively during surgery. Everything was suddenly on hold.

I knew this was absurd. I have never, ever had a bleeding problem. I get regular tests as part of my diabetic checkups, and it’s never been an issue. So, I had ample information to support the idea that this was a mistake. However, those things have no meaning in situations like this. I just had to suck it up and deal.

I went back to my regular doctor. He tested me and the platelet count was, of course, fine. He arranged for me to go to a blood specialist, who tested me yet again and found the platelet count was fine. He was annoyed (though not with me) at the having to have me come in for what was so obviously a bad test to begin with. Why didn’t the hospital retest in the first place? Because they don’t have to and it’s easier to put the problem on the patient. So I (or more properly my insurance company) had to shell out a chunk of money and waste my and various doctors and other people’s time rather than retest. How stupid can we collectively be?

Sorry – I digress

I was lucky that I was able to get all this done and get the sign off I needed to keep on schedule.

Surgery Day:

So, we come down to it. The day of surgery I was a bit nervous, of course, but ready. I wanted to get this behind me.

After some unremarkable waiting and check in stuff they took me back to the pre-op area. More people examining my privates. I wish it had been more fun. :) One minor snag was that the prep nurse wanted to cut off my wedding ring and another ring I wear, neither of which I have had off for at least 15 years. They were certainly not coming off on their own. Luckily for me, the anesthesiology nurse came in, who was pretty rational. She had the prep nurse just tape them over so there would be no chance of conducting a static charge, which is what they worry about. After a time the anesthesiologist came in and interviewed me to figure out how to knock me out. My wife came back to visit a few minutes. Then the anesthesiologist came back and they put a mask on me.

I mentioned before that I was a bit nervous about being put under. A totally new experience for me, and I had this vague idea of it being something like going to sleep without wanting to. Actually it was like flipping a switch. One minute – heck, one second – I was aware and talking with the folks around me, then next second it was two hours later and I was in a different room with different people. I had no sense of ever going to sleep or any passage of time. Rather than a pleasant or unpleasant experience, it was almost no experience.

At first I was a little groggy, naturally. But pretty quickly I was clear. My doctor came by and told me everything had gone well. An hour later I was on my way home, and feeling fine. Total time at the hospital was about 10 hours.

continuing

so - taking up where I left off

For a few years the pills worked pretty well. We used, at various times, Viagra, Cialis and Levitra. I think Viagra worked best for us in terms of reliability, but we liked Cialis because it stayed in the body a while and allowed some spontaneity. However, none of these was 100% reliable and, after a time, they ceased to work much at all.

We started seriously thinking about the implant option probably about two years ago, maybe a bit more. I think it was my wife who initially brought it up after doing some research on ED and actually seeing a video posted by some doctor on the treatment. My urologist also told me it was the most reliable solution. But, he suggested, and I concurred, that we try less invasive solutions first.

We first went with the pump idea. That’s the one where you use a vacuum pump to basically inflate the penis and then put a constrictive rubber band around it to maintain the erection. After some practice, I was able to get a pretty good erection this way, actually. However, it felt totally unnatural to both of us – my wife said it was like having sex with a cold sausage – and allowed no spontaneity at all. No Good. We tried the injections as well. (Caverject). Again, it actually worked reasonably well in producing a serviceable erection, but my penis would hurt for some hours afterwards and, again, no spontaneity at all. In addition, the erection was not all that great. I was told we could try other formulations that might work better, but the downsides of the injection approach just didn’t work for either of us.

I want to say that during this long period of looking for a solution, we continued to enjoy sex. We have had successful intercourse maybe 3 times in the last 4 or more years as of this moment, but sex is still great fun. My wife is very much my partner, and we just use other ways to enjoy and satisfy one another. So, what’s really the issue here? Basically, it’s the lack of that really deep intimacy that comes with intercourse. And, let’s be honest, there are a great many things that are very erotic and satisfying that simply can’t be done without an erection and we both miss them very much. Even with the constant problems of ED over the years, we’ve enjoyed great sex and intercourse has been part of that. We both want that back.

So we decided to go forward with the implant.

Now, I have to be honest here and say that I put it off somewhat because I was frankly afraid. This is a permanent change. Can’t be undone. I will never have a natural erection again. In spite of all the information (which, as I said before, was kind of limited from a real life experience viewpoint) I was given which said everything would feel normal and natural afterwards, I had trouble with that idea. What would it mean to how our sex life actually worked? What about masturbation – would that be “normal”? (Yes, everyone does that now and then). What about going to the bathroom? What if I was one of those very rare cases that became infected? What would happen then? What happens when it wears out in 15 years? It also bothered me a little that all the liturature said I would lose some length in the erection. Didn't bother me a lot, but a little.

And then there was the operation itself. I have been lucky enough to have never been seriously ill or injured in my life. I’ve never been in the hospital except for a handful of minor ER type situations. I’ve never even broken a bone. I’ve never been put under anesthesia, which really did bother me. What would it really be like? How much would it hurt?

But, at the end of the day, I miss that intimacy, eroticism and deeper satisfaction in our sex life so much…

Saturday, February 16, 2008

starting out

February 16, 2008

So, what is this about?

I recently decided to have penile implant surgery. As part of that decision, of course, I wanted information. I found just tons of clinical/medical/generic stuff, but almost nothing that took me beyond what my doctor told me regarding what to expect; what’s this really like. I consider myself to be very much like you; and we all want real life stories to help us understand what’s coming. Not because my experience will be exactly the same as yours, but my experience will provide some sense of what yours will be like. We’re not that different.

So, my partner and I decided to share this experience. Maybe it will help you a bit.

My plan for this blog is to provide updates on a regular basis for whatever period of time seems appropriate, meaning roughly that period of time where things are changing and there is something new to say. I also intend to open this so others can post. At this moment, frankly, I’m just not sure how to do so – I’m new at this – but I’ll figure it out. When I do, I’ll also figure out how (and if) this needs to be managed.

One note on images: I do intent to post images of myself; meaning my penis and general surgery area. Nothing explains like a picture. These will not be at all pornographic in nature, (and I'm not all that impressive :) ) but we’re talking “full frontal nudity” here. I think it necessary to tell the story. Certainly, one of the things I wanted to know but could not find much on was simply what does this look like immediately post surgery and thereafter.

Another note: I wish I had thought to start this before the surgery, but I didn't. I am about 3 weeks after surgery at this point, and pictures will start from there.

And another: I'm not going to spend any time here on the device itself, except as it related to my experience. There's plenty of published information on what the implant is and how it works. I got the 3 piece type, with the resevior in the tummy.

History and stuff

Let start with some basic information.

I am in my early 50s. I am an American living on the US east coast. My wife and I have been married for 27 years (wow) and have had a great life together. I am a bit overweight, was diagnosed with hypertension and type 2 diabetes some years ago. Erectile dysfunction has been part of my life, and our life, for years.

It’s always said that all men “fail” from time to time and it’s nothing to worry about. Years ago, my failures to have erections were indeed “time to time” and, aside from the frustration of the moment, I didn’t think much about it. I wonder now if these incidents were actually precursors of later issues. Can’t know for sure I suppose. However having erection issues when a man is in his late teens and early 20s, even if only occasionally, doesn’t seem within the norm.

In any case, Erectile Dysfunction became a real ongoing problem for me as much as 18 or 19 years ago, when I was in my mid thirties. My wife and I were really challenged to deal with this. This was before the introduction of Viagra, which really pushed the door open to beginning to accept this problem as a treatable, medical issue. There was little information and no real treatment. Many people thought it was always a psychological issue. And I thought so too, because I had no other way to look at it. Oddly, the problem would come and go (no dirty pun intended) on fairly long cycles. So sometimes everything would be fine for weeks or months, then it would come back. Stupidly, I never discussed this with my doctor at the time. Although I’ll credit myself with never being much concerned with “macho image”, I was embarrassed and, probably more importantly, had no information to suggest this was a common problem or that it was treatable. I have since learned that, even then, medical folks understood this was a common problem and there were physical as well as psychological components, although treatment options were indeed few.

Jumping to another topic for a second, I really have to say how wonderfully supportive my wife has always been on this (as well as all other) problems. It’s always been our problem, not mine. She looks at it that way and treats me that way. More on that a bit later. But I do love her.

In any case, we started hearing about Viagra in about 1995 or 96. I was still embarrassed about the issue and reluctant to talk to the doctor. Also, at that time this was still a “sometimes” problem.

Now, a brief side comment – I have since come to really understand how much this affected my wife as well. At the time I failed to appreciate how hard it was on her to not know what to expect when we made love. She never knew if it was going to be successful or not, and what she would have to deal with in terms of being supportive of me as well as her own experience. I thought as long as she was physically satisfied things were basically ok so far as she was concerned. I was very wrong on that. If you’re reading this it’s probably because you have ED. I’m telling you, talk to your partner. Really understand what ED means to her or him, not just you.

With my wife’s encouragement, I finally talked with the doctor sometime in 1997 (I think it was) and was really relieved that he did not laugh (really, underneath I was afraid) and it was very matter of fact. I recall too that I was surprised that he did not try to say what caused it – the source of the erectile dysfunction simply was not relevant. I got a prescription and it worked! Woohoo!