HIFU EXPERIENCE

So today is Monday. I am on a liquid diet for 36 hours before my procedure. Vitaminwater, Gatorade, apple juice, water...anything I can shine light through. (No orange juice).

I made arrangements to have a second 3T MRI the day before my HIFU procedure so I would have the most current images available. (The last 3T MRI was done 5 months ago and would probably be fine but I'm not leaving anything to chance if I can help it).

I arrived at 7:45 for the MRI. Filled out the paperwork, paid for the service and then a few minutes later was told the MRI machine is down for repairs. It's noon now and was told it is almost ready. I sure hope they test it OUT before they put me in there. I don't think I'm ready to become Magnetoman. Lol

Thanks for providing more info, it's now a bit better for me to understand your reasoning, I am too GL6 with 10% in one core only, PSA 6.4, and staying on AS, but if things get worst I will go with FLA with Dr.Walser, if you never heard about Dr.Bush in Chattanooga, TN, you obviously have not read thousands of posts on FLA and probably hundreds posted recommendations for Dr.Bush on website

inspire under  Focal Laser Ablation patients, there is currently 4805 posts on this topic. Dr.Bush did review my mp3TMRI CD images done by Rolling Oaks Radiology in Thousand Oaks, CA. He is only doing prostate MRI and MRI guided biopsies, that's all he does, he is considered the best in USA, just read all recommendations at inspire, I been following this thread for the last 9 months and read all 4805 posts,

regards, Andrew

He is consedering also using FLA for prostate reduction in BPH conditions which is what I have. I have also just visited Woodbridge VA to meet and discuss Prostate Ardery Embolations with Dr. Bagla who is the most exprienced in PAE in the US. Then, the next day,  I drove to Chapel Hill U of North Carolina to meet and discuss PAE with Dr. Issacson who is the second most experienced in PAE in the US.

My current game plan is to have a 3T  MRI with a pelvic coil next week to verify no cancer. If so I will choose one of these two and first have the PAE. If no success with that proceedure, I will then consider the FLA to reduce the prostate. If Walser does find cancer next week I will have a targeted biopsy and determine the gleason score. Based on that,  and would prefer FLA. 

A side note in this decission  is that they have found that with FLA, they usually get very good reduction in prostate size which improves all the BPH symptoms. So I have a decision tree set up here to use the methods for treatment that limit the horrible side effect of the many treatments that are offered. I am 65 years old and trying to squeeze another 20 great years out of life. FLA and PAE are the best things going now. Thank you for the information and I will check out Dr. Bush. I will tell you that Dr. Walser is a wonderful Doctor also. I cannot tell you enough about what a fantastic person he is as well. Sometime you dont get both in this profession.

So, they finally got the MRI machine up and running. 7 hours after I first arrived I have the images and on my way to see the Urologist. The results were no worse than first MRI...Same two areas of concern.

Plan is to burn those areas with HIFU. Then hit the other two areas that are pre-cancerous for the purpose of reducing the pressure on the urethra and help with urinary flow. Seminal glands are spared, nerves are spared, urethra and bladder neck are not damaged. Best chance for no long term side effects.

I asked why he no longer does the FLA procedure. His answer was that it is not as precise. He explained that the laser emits and spreads out like in the shape of a grape. The power of the laser tapers off the farther it gets from the diode. HIFU uses ultra sound with pin point accuracy. Think of the sunlight going through a magnifying glass and it only burns a precise point. But instead of light, it's sound waves. Also, a big negative is the laser diode must be pushed through the rectum wall so more invasive and more chance for infection (just like in a biopsy).

I have been on a liquid diet for 31 hours now. Has not been too bad. As long as I keep fluids in my stomach I really haven't missed solid foods. I'm a little surprised it has not been more difficult as my stomach almost always lets me know when it's time to eat.

I must stop all fluids at midnight tonight. Then, in the morning, I have to give myself two Fleet enemas. We'll see how that goes...pun intended lol. I must be at the clinic at 7:00 a.m. so I probably won't have time to post before the procedure.

I must say, I have had 9 other operations/procedures during my life (almost all from sports accidents). This is the only one that I can honestly say I have been apprehensive about. I think it's the right decision and best alternative and I believe everything will turnout ok (or I wouldn't move forward) but this is tough.

Well, it's Tuesday morning @ 6:30. I have been up for hour and a half. Took my Cipro antibiotic and did the two Fleet enemas. Took a quick shower and now time to head to the clinic.

Hi everyone,

I am out of recovery and back in my hotel room.

So the prep time takes about an hour before the procedure. They go over your medical history, anything you're allergic to, some forms to fill out and sign and then you strip and put on the surgical gown.

Then IV is started. Next they go over how the Foley catheter works, how to change the catheter bags from day bag to night bag, cleaning the ports, and putting the plug in the tube when I shower. (They do this before the procedure so you will remember).

Next, off to the procedure room with a quick stop to the bathroom on the way. They have you walk down the 15' to 20' hallway and into the procedure room in the ever famous open gown in the back. Yep...I could definitely feel a draft. Not a big deal, my wife says I have a nice backside lol.

Step up, slide onto the table and laydown. actually somewhat form fitting table and comfortable. They are adjusting me on the table so I'm in the right spot on the table. They are putting my arms on the supports out to the side. Then I hear..."You should start to feel the anesthesia. Do you feel anything?". I said, "I'm starting to feel something" and then I was out. (Will post more later)

Ok, here is my report on the first 18hrs. Post op. I wake up and my first thought was, my procedure is over.

Second thought, I have a catheter, let's take a look! Then nurse comes over and says..."No, don't touch it" (sounds just like my mom when I was a little kid. Lol.) (just kidding). But the nurse really did tell me not to touch the catheter without washing my hand first so that I minimize the risk of infection.

Third thought is the tip of my penis really hurts. Then my wife joins me in the recovery area. The recovery areas are not individual rooms, just one large room that separates patients by using pull curtains. The nurse tells me the pain in my penis is normal. She grabs some Lidocaine squirts some on her finger and demonstrates to my wife how and where to apply it. (Did I forget to mention there is no modesty in this process? Lol) Im just trying to add a little humor as I write this. After all the nurses, doctors and assistants that have seen, touched, and prodded my private parts, plus your totally naked for the actual procedure with everything exposed to the 10 to 15 people in the room (I was already knocked out when this part happened) well...my private parts aren't so private anymore. (Plus, no one ever seemed impressed so it's not like I could charge anyone for a peek lol). I was fairly well prepared for this and everything else as I had done some extensive research through reading, videos, and talking with men as to what to expect. Also, when I made the appointment for the procedure, they send information as to the steps involved. So really no surprises and not embarrassing. Something I often say..."it is what it is".

So, no pain felt internally (in the prostate) and I would say I probably didn't need any additional pain meds for after the procedure as it relates to internal conditions. However I did take anti-spasm med. which I did need. They gave me 3 anti-spasm pills right after the procedure and then instructed me to take another when I returned to the hotel. I did have some spasms about 8:00 p.m. and was instructed to take another pill immediately. The spasms didn't hurt, at least mine didn't. It felt like when you all of a sudden need to pee. Then the sensation when you relax and let the urine flow out. When this happened, some of the urine came out between the urethra and the outside of the tube. I was laying on the bed naked from the waist down with a pad under me and with so little an amount escaping, it was really not a big deal. I think some men have pain with their spasms but not the case for me.

So the only real pain (and I mean REAL pain was at the tip of my penis to about 2 inches back. I think this is more of an isolated incident because nothing I researched indicated what I was in for. The pain at the tip was like needles stabbing or a sharp razor edge cutting the inside of my urethra. The pain was the most intense at the tip and went down to mildly discomfortable. I didn't want to move an inch or even a millimeter) as just the slightest movement magnified the pain. I had requested a pain pill from my doctor the day of my consultation. He grabbed his prescription pad and asked what I could take (because I am allergic to Vicodin. He then said He really doesn't think I will need any pain medication. So I let him talk me out of having a pain pill as a contingency. That is my only regret at this time. I would have preferred to have a pain pill available and not need it than to need a pain pill and not have it. So needless to say, I didn't sleep well last night.

So here's a bit of good news (at least I think it is). I had two erections this morning. They both woke me up as they were not comfortable (This may sound strange but even though I was glad to see it working so quickly, I really wanted them to go away). The catheter put a damper on the excitement and they weren't hard enough for penetration but hey, they were a nice surprise.

This morning, the pain level from the catheter is only about a third as bad. Internally I feel great. No pain what so ever.