Going with Focal Laser Ablation for BPH

Ok, I had the procedure yesterday, I was amazed at how the conscious sedation worked. I really felt nothing not even the Foley catheter they place in me to pump the cooling solution into my urethra. Dr. Karamanian was schedule to do my ablation but was busy with and critical cancer case scheduled for the same day so Dr. Walser did the procedure but Karamanian is going to help me through post op along with D. Sartin who was the attending nurse.

The procedure was wonderful I think though I do not remember any of it. Dr. K reviewed my MRI after the procedure and told me it as a fantastic job and because a lot of tissue was removed by Dr. Walser I would have long term results. I will not be able to start seeing results until this catheter is out in about 4 to 5 days.

I do not have much to report as I cannot tell anything right now. My wife and my 85 year old Dad who came with brought me to the NASA facility to view the exhibits. Very fitting with the recent passing of the great John Glen. I have been given several drug which I will cover in my next post. I am on my cell phone now and sorry for the typo's in the message. so more information when I get a computer. I will post it on my other location "Going with FLA for BPH".

I am just 4 days into this:: Not a lot to report. I was shocked to awake in the night for an erection the last two nights. Don't need or want that right now! It did not cause any problems.

I will stop the Alfuzosin pills on Monday. But things are improving slowly. I can tell I am swollen inside but I do not hurt much. When I drive my truck it feels like I am sitting on a golf ball. 

Dr. K said in 3 weeks I will be peeing like a 50 year old and in 6 weeks like a 40 year old and in 8 weeks like a 30 year old. Currently my pee is blue as I am taking this great drug called Uribel. It is a relaxer of the soft tissue and pain pill. 

My gland was very large 125cc. That is almost the size of a tennis ball. They removed almost 30% of selected tissue.

If you will send me (PM) with  your email address  I can send you pictures of my MRI before and after side by side and you will see exactly what they removed and where they removed it. I dont have a lot to report except I think it was a mistake to spend the day after the procedure tourting the NASA Facility. I rode around for 90 minutes on a hard seat of a big Tram that was like Wally World and I wish I would have stay more clam that soon after the procedure. There is some blood but it is little as the Doctor said it would be less than 5cc of blood in this procedure. The swelling will go down in the prostate as the coagulated tissue is absorbed by my white blood cells and removed as waste from my body. This just takes time but does not seem to slow me down so far.

I went for FLA this week on Monday. Drove home finally yesterday and that was a 6 hour drive from Houston. Catheter came out this morning which was 5 days post op. Took it out myself and nothing to it only a couple of spoonful of blood came out in the shower.  I am  swollen but I am peeing about 100 to 200cc now every 2 hours. Not sure how or when I will be happy but believe I will be. 

The procedure was nothing and I really cannot remember anything. They use a concious sedation medicine like what you get in a colonoscopy. I remember signing paper and then they woke me up to leave. We went to eat seafood on the way to the hotel. 

They really took out a lot of tissue. The Doctor came from the hospital to my hotel the night of the surgery with his laptop and showed me, my wife and my Dad the picture results of the procedure and my prostate as it showed on the MRI both before and after the removal of all the tissue. He claims in a month to two months I will be peeing like I am 18. I know he did not hurt the important things as 3 of the last 5 days I have had an erection already. That was a shock.

Since the day of the porcedure Dr. Kara main ian has called us everyday after he has left his office to check on us. It has been very comfroting to have that type off attention from a doctor. I ask him if they do that for all patient and he said yes but most of his cases of focal laser ablations are for Cancer and he is just use to doing it as Cancer patient need more support cause they are going through a lot and need the extra communication. I told him how much it had helped me and my wife as we were scared daily about this thing and the changes.  I am not sure Dr. K  will call tonight as he has left for vacation to visit his family in Florida.  

Last night in our talk, he said he want a game plan in case we needed it, and he explained what to do if I swell up inside again and the urerthra is clamped shut from inflamaion. He told my wife when it would be appropriate to take me to ER and exactly what to tell them to do and especially what not to do. He gave us his cell phone and said if you get into any situation you call my cell phone direct no matter what day no matter what time. This made us feel great about the money I spent on this procedure. I wish we could have waited and been in the clinical trial I think he will have in the next month or two.Not sure of where it goes from here with me but I no I have a great doctor who cares more about my health than money.

If anyone wants picture from the MRI of the before and after of my prostate in which you can see what they removed around the urethera and up where the bladder was pushed up from the center lobe, just personal message me and I have a copy I can send of before and after side by side. It is pretty amazing to see the difference. MY Prostate was 125 cc before the procedure. I dont know the size yet but he said it was about 30% removal. We have to wait for the coagulated tissue to now be absorbed by my body and past out as waste then it will close up those holes and shrink down.

Everyone Gods Blessing and have a wonderful Holiday. 

John

I have been slow to report on progress as it has come in small doses until this week. I am humble feeling at the moment as the changes I am now experiencing are ones that I felt when I was younger and I dont think I really thought they would come back. That is the relief of fully voiding and the strong flow that not only feels so good it sounds wonderful.  i have posted this in a couple of places but wanted to make sure I got it out to the people who are following this thread. 

Twenty days post op and set some new achievements. This week my volumes have increased dramatically. I went from 75-100 range to now I am going 250 to 500 each trip. Flow is really good. I am enamored with the flow as I have not seen this in years and it is hard to believe it. 

My nighttime trips have gone from eight a night down to two a night and last night was a FIRST! I did not get up to pee all night until 6:16 am. I am pleased but also know that I can expect some relapses over the next month or two. WHY? It is just what sometimes happens “ebbs and flows” with any procedure is the natural recovery rate

Dr. Kara man ian told me that the period I am in now is called “reforming”. He said it is where the prostate is taking on a new shape as the laser voided area are clearing out the tissue and collapsing inward to form a smaller and new shaped prostate footprint. Those of you that ask for and received my MRI before and after pictures can look at those and see where this might happen. Dr. K says it will just get better over the next 60 days. He is still encouraging me to ejaculate but I am not ready just yet. I can still feel the swelling and I don't want to deal with a disappointment right now as I am so happy. I will wait until next week. He says it will be fine. I know that the recovery protocol for TURP surgery is to wait 2 months to ejaculate in that procedure. He assure me that all the sexual equipment is there and in good shape. I know the erection part is fine and I was experiencing that since day 3 post op. 

Dr. K once again told me that they usually do not take out as much tissue as they did with my prostate and the recovery is easier. I did not tell him but I did not think my recovery was that difficult??? I think I was surprised that the retention  I was having from the large prostate pushing up into my bladder was relieved so well from the tissue removal. Emptying the bladder feels so good as it had been a longtime since I had felt that relieve.

They removed the protruding bladder tissue, they removed a suspicious spot that was in active surveillance for the prior year and a half and the removed three channels along and on three sides of the urethra to free up the stricture that was pinching my flow down to nothing with the BPH.

I am very happy with Dr. K. who seems even more excited by my current report than I am. 

Monday 1-9-17 Happy New Year now has a new meaning for me. I am at day 21 post op 3 weeks. This weekend I felt many changes and they were very strange. First the urgency melted down to a new and better level. Second, I am use to peeing every 45 minutes to an hour and that was hard and somewhat scary as it changed. I thought maybe I was blocked. NO NO I don’t mean I am now peeing that much, I MEAN for the first time in a long time I am NOT peeing that often. Today for example I got up at 7:00 am. ( I am normally at work by then.) and I did not urinate again until about 1:00 pm. I had No strong urge and no  incontinency  when I did have to go at 1:00. And I had two big glasses of ice tea for lunch. Third, for the last 3 nights in a row, I did not get up but one to zero times. This is another strange feeling for guy who has dealt with bad nocturia for several years. All of these changes have come in the last four days since Friday of last week. Yes, I am happy but it is a strange feeling having it really happen. 

I did not expect that I would find it strange but I was so bad with BPH symptoms that I had built my life around it. I actually have "choice spots" on the golf course I play where I take my usual urine stop about every other hole. It has become second nature to me and now I will not do that anymore. It will be strange. I wonder if my handicap will be effected? 

I am very happy with these results. I feel truly blessed and thankful. Dr. Kar a man ian keeps telling me that my procedure was extra aggressive and that they usually do not take out as much tissue as they did with me but I got "three birds with one stone" in that;  (1) the suspicious dark area that has been under "active surveillance" for the last 14 months was removed, (2) the large median lobe that was pushing up into my lower bladder and causing retention was removed, and (3) on three separate sides of my urethra tissue was removed forming three channels that were a up to a half inch wide and up to 1.5 inches long to free the pinching of the urethra so I can pee like a young man. When you have a prostate the size of a tennis ball you can do this remodeling. 

So far, I am amazed because it has all worked and yes it is strange to be seeing and feeling this results. I did not realize how I had accepted my life changes that I had developed to live with BPH to this degree. It is awkward as these BPH symptoms are leaving my lifestyle. I am accepting these changes cautiously but Dr. K. says the BPH symptoms will not be back and that is the blessing from the amount of tissue removal that was done. 

I have some great pictures of the removal area if anyone wants to see. I have sent several out. I just need your email address.

Dr. K was the key to all this as I can not tell you of the post op care he has given me. His concern and support is hard to believe and I was there!! You will not get this from most Doctors. It is not the typical "see you in 4 weeks" as you leave the procedure. This doctor actually calls me. Yes, he waits until his day is over and he is heading home and he then calls his new active procedure cases to support them to a point that he feels it is needed. 

To me, it was a lot of money on 3 separate credit cards as I can't write that type of check, but it is starting to feel like it is the best money in my 65 years that I ever spent. 

Anyone who wants details just personal message me and we will get together to discuss as want to help anyone interested in this procedure know all the facts. 

By the way Dr. K is setting up a clinical trial and I did not know or care what is all involved in that as I am not going to be involved but I did find out that he has to file it properly and set it all up with some official organization. Then he is covering a sizable percentage of the cost. He is going to do at least 7 up to 10 men in this trial. He will then do all the publishing of the results as of certain date milestones. If anyone has interest you should contact him.

Hope that can be used to someones benefit. I don't care that I paid full price it was well worth it to me so far and I think it will only get better. He says it will and what I have at 120 days is what I will have. I know I am still swollen in my prostate but I also know it is going down fast. He calls this the "reformation phase" of the recovery. 

I hope this post helps someone and I will keep doing it from time to time if it is wanted?

John