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TURP Operation, Still Suffering


ThaiPauly

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26 minutes ago, uhuh said:

Make this "back in the USA".

It is (still?) quite popular in some European countries where there is no opioid addiction crisis (yet).

oxycontin is still getting the tick in the prescriptions box in Australia.

I was on it for over 3 years... 

 

only problem with finally coming off it, wasn't any to do with Withdrawals... 

 - it was the having to be in hospital for a week, getting continuous Ketamine Infusion!!

Now THAT is what made 'me' sick as a dog...     

 

when me Dad had that operation, he was too proud to keep wearing the Incontinence nappies... 

 - he wore condoms... with a full packet always with him 

  He started doing that; after one day driving himself home, he had a 'bigger than the nappie accident' on his velour carseat!  - the worst part was that he was pissing mostly blood (cancer) 

The plus though for him (all in the mind) was that at over 80, wearing a 'dom again made him somehow feel like a young buck again! 

 

... pity the condom kept blowing off too under the pressure

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3 hours ago, ThaiPauly said:

I have just got back from Bangkok Hospital where I have had a catheter fitted.

 

Just as well as it half filled immediately. So any danger I was in has passed for now as long as I keep the catheter in.

 

Sheryll, you say go to ER at Suan Doc but I went to supposedly the best Urologist in CM at what is supposed to be the best hospital in CM. It would have been much cheaper to have the operation at a government hospital but this Doctor was recommended on this forum and was trained by Dr.Bunnakit.

 

What on earth is a guy gonna have to do to get it right in this country?

 

I will be speaking to Dr.Wittawatt first thing in the morning to see what he has to say for himself and where we are supposed to go from here

 

Has the pain stopped with the catheter placed?

 

if so then the pain may just have been from urinary retention which is not that unusual post TURP.

 

If even with the catheter the pain continues then something else is going on.

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15 minutes ago, Sheryl said:

 

Has the pain stopped with the catheter placed?

 

if so then the pain may just have been from urinary retention which is not that unusual post TURP.

 

If even with the catheter the pain continues then something else is going on.

Hi Sheryl,

 

It's just uncomfortable now , especially with the cathetar , but not much I can do about that. It was

 

The pain came from pushing when trying to urinate. It was a real burning pain. As I no longer need to urinate it has now gone

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1 hour ago, Oliver Holzerfilled said:

Gulf Air will transit in Bharain.  Here is the relevant text from the Customs website -

 

"Passengers may bring into the country, medicines for personal use only. An original prescription from a registered medical practitioner must be enclosed (stamped and signed by the relevant medical authority with full details of the patient and medical condition). All medication should be in original packaging and should not have expired.

 Hallucinatory or psychotropic medicines and drugs are not permitted without a prior approval from the Ministry of Health.  Any passenger found with such medicines will be liable to prosecution under the relevant laws."

 

http://www.bahraincustoms.gov.bh/page.php?SID=WTBkR2JscFVNREZPYVZwMFVGUlpiV015TURsT1ZFazk%3D

Thanks very much Oliver, you have saved me a job

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1 hour ago, ThaiPauly said:

You are not joking it is the most expensive, but there was no mention on here of a decent urologist at Suan Doc

 

Also, how long can you keep a catheter in before it needs replacing? Obviously I can empty the one I have, but after a TURP operation I should never need a catheter!!!

Had a TURP in Nov2012 in Adelaide.  After three days in the hospital after surgery, I could not urinate.  Eventually, I was (re)fitted with a (home) catheter which remained for three weeks.  After the three weeks, the surgeon was so happy (and surprised) that I had no infection that an an overnight hospital stay was immediately scheduled for the following day.  Catheter was removed and I was sent home.  Urination is still only marginally better than before I had the TURP.  Surgeon had promised huge flows.  Alas.

 

So I feel for your situation and the confusion that you are feeling. It's now been seven years for me but I get along ok.  Hope you also arrive at a satisfactory outcome.  Cheers and best of luck.

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On ‎9‎/‎7‎/‎2019 at 10:56 PM, ThaiPauly said:

Thank you for your very helpful response Xylophone, you have given me some hope that I may improve.

 

Luckily for me I can still pee though it hurts like H*ll, so I may get away without another catheter.

 

One thing I did not mention is that for me healing of any wound /operation takes longer as I have type 2 diebetis. But even sitting on my office chair is painful on my sternum, so I will now get back to the sofa

 

Thanks a lot for your words, they have given me some hope when I could not see a light at the end of the tunnel.

Not drinking leads to other problems so not recommended. 

You may be able to do intermittent catheterisation yourself if you can get a supply of catheters and training.

Perhaps you need a catheter in place for a while to allow healing. I had one for over a week after prostate operation.

Regardless, need to talk to consultant that did the op.

 

An air ring could help the painful sternum.

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It is not unusual to need a catheter temporarily after a TURP.

 

More common in the first week than 10 days later but can happen and in some cases take months to fully resolve.

 

It is usually caused by post-operative swelling in the urethra and/or edema around the neck of the bladder.

 

Rarely (like 1% of cases) a complication called bladder neck contracture occurs and that is more complex. If the retention (inability to fully empty your bladder) continues for more than a few weeks a cystoscopy may be indicated to take a look at the bladder neck .

 

My prior advice re ER etc was based on the reported extreme severity of pain and overall disability you seemed to be describing (so bad you could not stand/walk, expected to be denied boarding of plane, could hardly function, wanted ultra-strong narcotics etc etc). This sounded like something much more than urinary retention.

 

But if the catheter has brought relief then retention is likely all it was. as above, this will usually resolve with time though in some cases can take months in which case you may need to learn to self catheterize intermittently as that is better than leaving an catheter in place for a long period.

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ThaiPauly,

 

Did you have the older, hot wire TURP, or the, Laser TURP? I've heard pain when urinating is common with the older TURP.

 

 I had Laser TURP done in India, 2 1/2 years ago. The surgeon told me there would be no pain, no incontinence, and no erectile problems.  He was right.

 

 However, after a week in India, I got home and there was no improvement in my condition. I wrote to the Dr., explained what was happening and he said I shouldn't be having problems. He said I could have developed a stricture and to go to my urologist and have him insert a Foley catheter into my bladder and then remove it. Well, my urethra was REALLY tender, so that wasn't going to happen.

 

 I was not too happy and didn't know what to do, so I did nothing. Then, after 3 weeks, I noticed some improvement. After that, it got better and better and by week 8 I was satisfied with the results. My urine stream was strong (not like a fire hose as some say), and it was steady. No more stop-start, stop-start, and never knowing when I'm finished. I could leave the house, run errands, visit someone and not have to <deleted> till I get home!

 

 There was very slow improvement for a full year until I felt that's as good as it's gonna get. There was another TVF member who went to India after me and his story is very similar to mine.

 

 I was under the impression you walked out of the hospital and everything was fine, just like a kid again.

 

So, ThaiPauly, I hope this gives you some comfort. It just may take awhile. 

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Been back to see the doctor this morning, he was very concerned and gave me a lot of his time.

 

He took a sample of my pee to create a culture so at least if I still have an infection when I have to go and see him a week today he will have a better idea of my condition.

 

He is very confident that it will come right, which is very good news.

 

It's just the awkwardness of the catheter no for the next weeks, but I'll get used to it Britman has had his for ages I think...a very brave guy, especially putting it in himself.

 

I could NEVER do that

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6 minutes ago, zlodnick said:

ThaiPauly,

 

Did you have the older, hot wire TURP, or the, Laser TURP? I've heard pain when urinating is common with the older TURP.

 

 I had Laser TURP done in India, 2 1/2 years ago. The surgeon told me there would be no pain, no incontinence, and no erectile problems.  He was right.

 

 However, after a week in India, I got home and there was no improvement in my condition. I wrote to the Dr., explained what was happening and he said I shouldn't be having problems. He said I could have developed a stricture and to go to my urologist and have him insert a Foley catheter into my bladder and then remove it. Well, my urethra was REALLY tender, so that wasn't going to happen.

 

 I was not too happy and didn't know what to do, so I did nothing. Then, after 3 weeks, I noticed some improvement. After that, it got better and better and by week 8 I was satisfied with the results. My urine stream was strong (not like a fire hose as some say), and it was steady. No more stop-start, stop-start, and never knowing when I'm finished. I could leave the house, run errands, visit someone and not have to <deleted> till I get home!

 

 There was very slow improvement for a full year until I felt that's as good as it's gonna get. There was another TVF member who went to India after me and his story is very similar to mine.

 

 I was under the impression you walked out of the hospital and everything was fine, just like a kid again.

 

So, ThaiPauly, I hope this gives you some comfort. It just may take awhile. 

Yep you are right, I walked out of there and thought everything would be fine.

If you read the post I have just made you will see what my current situation is

 

Thanks for taking the time to respond

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2 hours ago, Sheryl said:

It is not unusual to need a catheter temporarily after a TURP.

 

More common in the first week than 10 days later but can happen and in some cases take months to fully resolve.

 

It is usually caused by post-operative swelling in the urethra and/or edema around the neck of the bladder.

 

Rarely (like 1% of cases) a complication called bladder neck contracture occurs and that is more complex. If the retention (inability to fully empty your bladder) continues for more than a few weeks a cystoscopy may be indicated to take a look at the bladder neck .

 

My prior advice re ER etc was based on the reported extreme severity of pain and overall disability you seemed to be describing (so bad you could not stand/walk, expected to be denied boarding of plane, could hardly function, wanted ultra-strong narcotics etc etc). This sounded like something much more than urinary retention.

 

But if the catheter has brought relief then retention is likely all it was. as above, this will usually resolve with time though in some cases can take months in which case you may need to learn to self catheterize intermittently as that is better than leaving an catheter in place for a long period.

I will keep the catheter in for 7 days now,  and will review the situation when it comes out next Monday.

 

If I have to learn to self-catheterize as much as the idea fills me with dread I will just have to do it

I'm hoping it doe not come to that though

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38 minutes ago, ThaiPauly said:

I will keep the catheter in for 7 days now,  and will review the situation when it comes out next Monday.

 

If I have to learn to self-catheterize as much as the idea fills me with dread I will just have to do it

I'm hoping it doe not come to that though

I understand emergency departments can assign a nurse to insert a catheter. Still not pleasant. Perhaps BM2 can confirm cost.

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1 hour ago, ThaiPauly said:

It's just the awkwardness of the catheter no for the next weeks, but I'll get used to it Britman has had his for ages I think...a very brave guy, especially putting it in himself.

It was only for a month, couldn't wee at all, no previous signs.

But the drugs worked well, still have to be careful with alcohol and dehydration, that brings it back.

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12 minutes ago, Lacessit said:

I understand emergency departments can assign a nurse to insert a catheter. Still not pleasant. Perhaps BM2 can confirm cost.

It was around 250bht for a nurse to put it in or change it, including the catheter and bag (usually the prettiest and youngest nurse on staff). Always in the emergency department, fair bit of waiting around.

SanSai hospital on the road between MaeJo and Mae Rim.

 

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4 hours ago, ThaiPauly said:

If I have to learn to self-catheterize as much as the idea fills me with dread I will just have to do it

I'm hoping it doe not come to that though

You would be surprised what you can do TP if you have to!!

 

I had to self catheterise about three times a day after I had the permanent catheter and bag removed in Australia, and I did this for about a week or more (can't remember exactly as it was over 10 years ago).

About a year ago I was finding it difficult to pass water again and some bladder neck surgery was done here, and I don't believe it was done well, however for up to a month after that I had to self catheterise to "retrain my bladder" as the specialist said. Even now I have rubber gloves and spare catheters in the house just in case I have to start again.

 

I did start to pass water again, but to no great extent and that has remained until this present day, when I worry that I may have to get another TURP of some description done, as apparently the prostate can grow back again within this timeframe. 

 

If I do have to have another operation, then I will go to Australia and try to get the REZUM process as the whole thing is over and done with in about 30 minutes and one can walk out after the surgery. It may be new although it has had some field trials and is seen to be successful, however I will put up with the uncertainty rather than go through the <deleted> that I have been through over the past 10 years.

 

All the best and remember that there are other folks on here who have had similar and it has been many weeks if not months before they have come right again.
 

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8 hours ago, xylophone said:

You would be surprised what you can do TP if you have to!!

 

I had to self catheterise about three times a day after I had the permanent catheter and bag removed in Australia, and I did this for about a week or more (can't remember exactly as it was over 10 years ago).

About a year ago I was finding it difficult to pass water again and some bladder neck surgery was done here, and I don't believe it was done well, however for up to a month after that I had to self catheterise to "retrain my bladder" as the specialist said. Even now I have rubber gloves and spare catheters in the house just in case I have to start again.

 

I did start to pass water again, but to no great extent and that has remained until this present day, when I worry that I may have to get another TURP of some description done, as apparently the prostate can grow back again within this timeframe. 

 

If I do have to have another operation, then I will go to Australia and try to get the REZUM process as the whole thing is over and done with in about 30 minutes and one can walk out after the surgery. It may be new although it has had some field trials and is seen to be successful, however I will put up with the uncertainty rather than go through the <deleted> that I have been through over the past 10 years.

 

All the best and remember that there are other folks on here who have had similar and it has been many weeks if not months before they have come right again.
 

That sounds terrible, and you have my complete sympathy. I got the guernsey ( on a much lower level ) by being catheterised six weeks in a row during BCG treatment.

While I seem to be keeping obstruction at bay with saw palmetto, the REZUM information is very interesting. Thanks.

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Thank you all for posting,

 

The levels of support have been amazing, Never before in 15 years have I experienced so much positive energy from a thread as I have from this one.

 

I have had pm's , phone calls from people  I have never spoken to before giving me support and not ONE poster being spiteful or just a stupid a*sshole.

 

For this I thank you all very much, having not had this condition before I am now very aware of the consequences of certain actions, what do do /not to do etc, and whilst I appreciate you are not doctors you have been where I am now and on some occasions there is no substitute for experience.

 

It's these kinds of non-bickering helpful threads that make Thai Visa, and the other types where people have to have their say about stuff they know nothing about that spoil it.

 

This is one of the good ones, and although it's nowhere near over yet I thank you profusely for your help so far.

 

Paul

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22 minutes ago, connda said:

ThaiPauly.  Did Dr Witawat perform a standard TURP or did he perform laser surgery? 
Hope things get better for you quickly.  Hang in there!

Hi Connda,

 

It was the standard procedure. The doctor made scant mention of the laser.

 

It's way more expensive though. I don't know how much it is at Bangkok Hospital but at Bumrungrad prices start from 400,000 baht

 

But they say it's less painful with a faster recovery time.

 

If I was a middle eastern gentleman with oil money to burn (which a lot of Bumrungrad's patients are) I would have gone for that, but alas........

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4 hours ago, ThaiPauly said:

Hi Connda,

 

It was the standard procedure. The doctor made scant mention of the laser.

 

It's way more expensive though. I don't know how much it is at Bangkok Hospital but at Bumrungrad prices start from 400,000 baht

 

But they say it's less painful with a faster recovery time.

 

If I was a middle eastern gentleman with oil money to burn (which a lot of Bumrungrad's patients are) I would have gone for that, but alas........

There is another thread in the CM forum.  Dr. Witawat also performs Thulium laser enucleation surgery.  According to the thread I believe the price was 200K THB.  The Op TracyB had the procedure a couple of months ago and seems to be getting on fine.  I've put off surgery because TURP until recently has been virtually the only option that Thai doctors will perform and I've refused to go with TURP because I keep reading posts like yours.  I feel for you.  I really hope things get better for you soon. 

 

 

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2 minutes ago, connda said:

There is another thread in the CM forum.  Dr. Witawat also performs Thulium laser enucleation surgery.  According to the thread I believe the price was 200K THB.  The Op TracyB had the procedure a couple of months ago and seems to be getting on fine.  I've put off surgery because TURP until recently has been virtually the only option that Thai doctors will perform and I've refused to go with TURP because I keep reading posts like yours.  I feel for you.  I really hope things get better for you soon. 

 

 

Hi,

Still no regrets having the Thulium laser prostate surgery at BKK hosp. Chiang Mai.  My final bill was 210,000.

Dr. Wiitawat is the best!

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ThaiPauly,
 
Did you have the older, hot wire TURP, or the, Laser TURP? I've heard pain when urinating is common with the older TURP.
 
 I had Laser TURP done in India, 2 1/2 years ago. The surgeon told me there would be no pain, no incontinence, and no erectile problems.  He was right.
 
 However, after a week in India, I got home and there was no improvement in my condition. I wrote to the Dr., explained what was happening and he said I shouldn't be having problems. He said I could have developed a stricture and to go to my urologist and have him insert a Foley catheter into my bladder and then remove it. Well, my urethra was REALLY tender, so that wasn't going to happen.
 
 I was not too happy and didn't know what to do, so I did nothing. Then, after 3 weeks, I noticed some improvement. After that, it got better and better and by week 8 I was satisfied with the results. My urine stream was strong (not like a fire hose as some say), and it was steady. No more stop-start, stop-start, and never knowing when I'm finished. I could leave the house, run errands, visit someone and not have to till I get home!
 
 There was very slow improvement for a full year until I felt that's as good as it's gonna get. There was another TVF member who went to India after me and his story is very similar to mine.
 
 I was under the impression you walked out of the hospital and everything was fine, just like a kid again.
 
So, ThaiPauly, I hope this gives you some comfort. It just may take awhile. 
Were you happy with your India experience? finding a hospital, doctor and the cost? would you recommend exploring the India option for medical treatment?
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9 hours ago, ThaiPauly said:

Thank you all for posting,

 

The levels of support have been amazing, Never before in 15 years have I experienced so much positive energy from a thread as I have from this one.

 

I have had pm's , phone calls from people  I have never spoken to before giving me support and not ONE poster being spiteful or just a stupid a*sshole.

 

For this I thank you all very much, having not had this condition before I am now very aware of the consequences of certain actions, what do do /not to do etc, and whilst I appreciate you are not doctors you have been where I am now and on some occasions there is no substitute for experience.

 

It's these kinds of non-bickering helpful threads that make Thai Visa, and the other types where people have to have their say about stuff they know nothing about that spoil it.

 

This is one of the good ones, and although it's nowhere near over yet I thank you profusely for your help so far.

 

Paul

Paul,  Im sorry to hear that you're having so much trouble.  Regular TURP is more brutal than the Thulium laser procedure.  Having said that, and having had the Thulium laser by Dr. Wittawat at BKK CM hospital, (about 40k baht more expensive than TURP) I'll say that my pain while urinating lasted for several days after having the catheter removed.  I was catheterized for four days.  I drank up to 3.5 liters of water every day (sometimes a bit more) and pushed myself through the pain while urinating.  The pain finally subsided.

 

The night time urination frequency was high for the first couple of weeks  three to four times a night.  Pain in the area of my perineum lasted for about a month but was only mild, except while riding in a car when it was almost unbearable.  The bumps in the road irritated the whole area.  It finally subsided to the point where I could ride for 20-30 minutes.  Now that part is fine as it gradually improved over time.  My prostate was, in Wittawat's words..."HUGE".  I think it was about 120 ml or more.  

 

I had the surgery around mid-May.  I was greatly improved after six weeks. I feel fine now.   I still get up to pee once, sometimes 2 times a night.  I go down at 10:30... up to pee around 3:30 or so, then sometimes again around 5:30.  Usually I sleep through from 3:30 to my "get-up" time of 6:30.

 

I took steps to be sure I was never constipated.  Straining is b-a-d for the healing process.  Drinking ample amounts of water helped this.  I used some stool softening laxatives for a week post surgery and then occasionally afterwards for the second week.  Painkillers can slow down one's digestive track and make one constipated so if this happens...consider using laxatives.  I used "Senokot"  2 tabs late in the day.   They are very mild and very effective.

 

I completely understand the fear and trepidation associated with painful urination.  Please remember that water consumption is your friend.  The more the better.  Eventually the urination pain will subside.  The weaker the strength of your urine the less pain you'll have.  High water consumption will achieve this by diluting the acid in your urine.  

 

Did Wiitiwat talk to you about the possibility of seeing blood or blood cots in your urine?  Have you experienced this?  I had pink urine at the beginning of my stream and clear at the end each time I urinated.  This lasted for about a week or so.  After about two weeks I saw some funky, stringy stuff in the stream.  Turns out is was small blood clots and a normal thing after this type of surgery, according to Dr. Wittawat.

 

Havng a urinary infection will complicate things and contribute to pain while urinating.  Hopefully the new antibiotics will get this under control very soon.  I think once the infection subsides your urine stream should become stronger and stronger with less and less pain.  I can't over-emphasize the need to drink a lot of water.  Nothing but water.  Alcohol is out, excessive amounts of coffee should be avoided....  things that might tend to dehydrate you.

 

Paul,  I'm always available to talk to you about this.  Feel free to contact me by message here on the TV website.  

 

Let me know how you're progressing, ok? 

 

One last thought for your consideration......  I spent most of my time lying down during the first three of four weeks after surgery.  Lounging on the sofa, feet up, just to keep the pressure off the perineum area.  I had a soreness there and taking the pressure off helped a lot. 

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Tracyb,

 

Thank you for posting such a detailed report. There is so much in it I want to discuss with you, but would it be alright if I could get back to you tomorrow,? I am too tired to think straight today, I spent half an hour being worried sick about my 90 year old dad because I could not reach him on the phone...after I phoned my sister in the UK  to get her to find him  she told me it was Tuesday...I call him every WEDNESDAY, he is deaf and only answers the phone at pre-arranged times...what a stupid sod I am !!!

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1 hour ago, ThaiPauly said:

Tracyb,

 

Thank you for posting such a detailed report. There is so much in it I want to discuss with you, but would it be alright if I could get back to you tomorrow,? I am too tired to think straight today, I spent half an hour being worried sick about my 90 year old dad because I could not reach him on the phone...after I phoned my sister in the UK  to get her to find him  she told me it was Tuesday...I call him every WEDNESDAY, he is deaf and only answers the phone at pre-arranged times...what a stupid sod I am !!!

Contact me anytime!  Tomorrow I’ll be having my annual adventure at CM IMM for my retirement extension.  I’ll answer You as soon as possible after I’m done there, ok?  Keep drinking water!

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1 hour ago, Tracyb said:

Contact me anytime!  Tomorrow I’ll be having my annual adventure at CM IMM for my retirement extension.  I’ll answer You as soon as possible after I’m done there, ok?  Keep drinking water!

I will post something in the morning and you can answer it when you are done.

 

Good luck at immigration tomorrow, I will be praying for you

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Arghhhh,

 

I have just spent 20 minutes composing a post and it vanished.

 

TracyB, I hope your visit to immigration went well.

 

      I have answered all the points you have brought up "bullet point style" to stop me waffling

 

*     Wittawatt never mentioned anything about a blood clot, I did pas some bloody urine for a few days

       but that has stopped now

 

*     I am taking the tablets for constipation that you were taking, but after 3 days nothing so far

 

*     My rectum is giving me a lot of pain as is the catheter, but I suppose that is only to be expected

 

*     I am drinking at least 3 litres of water a day, trying to do it all before 4pm so I am not up all night

 

*     Wittawat never told me how large my prostate was, wheras Dr. Bunnakit (who trained him) told me it

       was large 3 years ago when i started having mild problems. In fact Wittawat has never done a rectal 

       exam on me, at least not while I have been awake

 

*    Lastly the BIG question TracyB...I know that eventually I will more than likely get better but will I be 

      well enough to visit my children, grandchildren and my 90 year old father in 20 days time?

 

 

 

Thanks for taking the time to read all this, I think again it took me 20 minutes but no matter, it's all for my benefit but my bum has gone numb now so time for the lay-z-boy Downton Abbey and some water

 

Thanks very much

 

Paul

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The rectal pain may be due to the constipation.

 

Try eating prunes and if that doesn't help try Senna tablets which you can buy at 7-11.

 

The longer the constipation continues the worse it will get and the  harder to resolve.

 

There is an oral  medication that will numb the urethra and stop the pain from the catheter. it is called Phenazopyridine  (generic name), brand names are Anazo,  Pyrizole, Sumedium , Uzone-T , Phendiridine , and Phenazopyridine T Man .

 

You may find it at a large pharmacy (does not require prescriotion) or else ask the doctor for it. It will dye your urine reddish orange so don't get alarmed by that.

 

With this medication plus relief of constipation I think you'll be able to make the trip homeeven if you have to do so with catheter in place.

 

 

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