Prednisone after PAE
Posted , 10 users are following.
Undergoing preliminary consults at Inova for PAE procedure. Was told I would be on Prednisone following surgery. Problem - I can not and will not take the prednisone regime of building up dosage and tapering down. I did this about 5 years ago for another problem and had EXTREME anxiety for over three weeks. I did not think I was ever gong to be normal again. It is NOT an uncommon problem. What did the rest of you take post procedure?? Surely there must be something other than prednisone. If I just have to take the prednisone, I will not go through with the procedure.
0 likes, 24 replies
tom86211 vigneron
Posted
I just had a PAE on Monday morning. Urine flow is just fine - possibly slightly better than before, but I have been taking 1 Tamsulosin (Flomax) every other day, and now increased to every day. Post Op information I got from the hospital said to expect some side effects for a couple of weeks, then max PAE effect at one month out. After that there would be some continued improvement for 6 months.
So, if you don't want the Pred ask for the Tamsulosin or other similar meds.
I decided to go with the PAE because the side effects are far less severe than TURP or Laser. Just read what some guys go through after these cutting/burning procedures. I'm talking about hospitalization, Foley catheters for days or weeks, blood in urine, retrograde ejaculation etc. These procedures require that the instruments go up through your urethra and that can really irritate that tissue.
PAE stats are almost as effective as TURP or Laser based on very latest studies just presented, so in a recent report "Dr. Pisco reported that the cumulative success rate within 6 months of the procedure was 89%, which declined to 82% for the 807 patients in the 1-3 year follow-up subcohort. Patients in the “long term” post-three year category had a 78% cumulative success rate."
I have been discussing the various BPH treatments here for several years, and have been reading all available studies - decided to go ahead with the PAE because it has the highest success rate relative to side effects. So far, and I am now 2 1/2 days home from the surgery, the side effects have diminished and I am feeling about as good as I did the day before I went in.
The only issue I had on the day of the procedure was that the last opportunity I had to urinate was as at 7am, with the surgery starting just after 8am. They give you IV fluids, which is basically diluted salt water. I was supine in a recovery room from about 10:30am and instructed to lie on my back for the next four hours. I had a condom type catheter attached, but was completely unable to urinate lying down. So, I requested a Foley, and at about 12:30pm that drained off 600cc of urine!
When I got home, yes, there was some burning sensation when I went to urinate, and my rectum was also a bit inflamed - I believe from the drug they give to constipate you so you won't have an "accident" during the procedure.
I seem to be fine now. All tissue irritation has calmed down.
I am going to do a separate PAE post here about my experience. If the PAE works for me, then I will be happy that I did the procedure. It if doesn't, I will consider something else next year.
Tom
j12080 tom86211
Posted
Yes I did and all the men who do FLA have a Cath for about a week but mine was not bad. I did my procedure in December of 2016. I went back to work the second week as I was on vacation for the procedure. No retro grade in fact no sexual side effects at all with the procedure. This was my main concern and why I decided I was only going with one of these two procedures. We went to lunch when I left the hospital and toured NASA for almost 4 hours the day after the procedure which I do not recommend to other. Strangely enough, I as a lot of FLA patients, had a erection the second day after the procedure was done even with a catheter in me. No pain but very unexpected!! Yes, it was gone before I went to NASA thank goodness.
Thanks for given us you information on your success. We need to remember where we were in this process before the procedure and help all the men we can in an effort for them to fine the best choice for their situation. There is a lot to consider and I believe getting a good urine flow analysis and a 3 TMRI so you can actually see what is causing the blockage is the first and most important step in deciding what to do. These two procedures are not fully covered by insurance yet so it can be expensive. We need these procedures to work for us.
Good luck
It is wonderful
tom86211 j12080
Posted
I learned about FLA (Focal Laser Ablation) last year and it seemed like a great way to go, but could only find one doctor who performed the procedure and he was all the way across the country. Also, it's not covered by my insurance (Kaiser). My PAE was done at Kaiser and only cost me a copay of $250.
Since you had yours in Houston it appears as if more IRs are doing FLA now.
Tom
j12080 tom86211
Posted
Yes, I am surprised you did not find the providers last year. Though I agree, there are not many IR's who have dedicated to this FLA procedure in the prostate. Prostate cancer with FLA has been done for a long time and there are many cases. There are many of these PAc IR's. I know of three (3) doctors at the time I did my procedure in December focused on FLA in the Prostate both for PCa and BPH. The key is absolutely in picking the correct person to do the job. As I said before, this is an Art as much as a Science and I think that procedural idiosyncrasy is a blessing if you pick the right Doctor. I did not care about the geography of the Doctor but I did not want to leave the country. I am so sorry I did not know of your searching last year or I would have gladly given you all the information I had to help you at that time.
I sincerely hope your PAE has given you the relief you need and I am glad it did not cost you much. FLA was expensive but as I have said many times if I would have known then what the results would be now, I would have paid much more for this great results. I put it on my credit cards and it was the happiest payments I ever made to a credit card company! I am very blessed and thankful I found the right solution and provider for me.
There are guys in this web site that did FLA after their PAE did not work or stopped working over time. They are also available to give their story and information to anyone it would help. Don't get me wrong PAE works for some men in some cases. But the blood flow will grow back and replace the restricted arteries over a period of time. The human body is made to do that.
I feel with BPH, one needs to know what the situation details are before you pull the trigger on a procedure decision. What is really causing the bad flow and urges? I wanted to see it with my own eyes. Your bladder condition is also a big consideration. The 3 TMRI read by the person who actually knows what they are look at gives you many answers to the questions of what needs to be done. Looking at the blockage on screen and then seeing the whole prostate and the components of the prostate not only allow for the outline of a successful removal of the symptoms but it provides the way to save the sexual value of the gland. No retrograde ejaculation or ED issues are caused when FLA is done by the IR that can map out and see exactly what and where things need to be done and then watch it in real time while doing the FLA. I also did not want a procedure that was intrusive to the urethra by being done up and through the urethra into the prostate. That was what started me down the PAE path, then later the FLA path as FLA comes from the other direction and not up the urethra.
Good luck and if you need anything in the future just ask and I will help with what I can. I believe with all my heart that we should never forget what we went through with BPH. And we should continue to pay it forward with helping other men who are scared and trying to research a remedy. Those who have questions should be able to get answers from other men who have gone through this. Doctors just think they understand. Unless they have actually been the patient they do not relate the same. Clinical success to a doctor is not always symptomatic success to a patient. There is a lot in the way of treatments out there to chose from now days. I believe that knowing as much as possible about your condition and not just believing what some doctor says, provides the best possible outcome. At times, men with BPH seem to be and they feel alone in there issues. I was there once. I know. There is no wrong decision, if it works. The mistake can be made in waiting too long for a treatment and causing other bad issues. I almost did that.
John
tom86211 j12080
Posted
John,
Thank you for your very helpful comment. I have been battling BPH issues for seven years. In 2012 I had a prostate biopsy and a small amount of cancer was found. A second biopsy lead me to treatment in 2014 - HD Brachytherapy. After that, I went through 5 weeks of complete blockage of my urinary system and had 6 Foley catheters put in, taken out, put in, taken out - over and over again, until the prostate swelling abated and I was able to pee again.
My prostate cancer is now gone with a stable PSA of 0.1 over the past couple of years. However, the BPH symptoms continue and my IPSS score is 25. I never get a good night's sleep. I use two medications to help me urinate. I want to get off the meds and have some type of normal life again.
So, after reading about all the other options, the PAE became my preferred treatment. I won't know if it worked for several weeks, but so far I am able to urinate, although there is some discomfort, as there was before the procedure.
In a year I will re-evaluate my situation. if I am still having issues, I will move forward to the next possible solution. I will continue to look for IRs that can do the FLA - perhaps the doctor who performed my PAE could do it, or refer me.
When I first inquired about PAE I was told that nobody had done this on a patient who had prior radiation of the prostate for cancer. I spoke with Dr. Isaacson at UNC and he told me last year that he had performed a PAE on a man who had been treated with radiation for PCa. So, I am not the first, but one of the first.
Thank you again,
Tom
Self-help tom86211
Posted
"I am going to do a separate PAE post here about my experience. If the PAE works for me, then I will be happy that I did the procedure. It if doesn't, I will consider something else next year.
Tom"
That's great to hear Tom, since it will help a lot of posters today and in the future.
Reading that you have had prostate issues for an extended period, and a bout with cancer, might be beneficial combing all of your experiences and thoughts in one post; many issues that you have experienced will cross the paths of many patients, and allow them to chime in and exchange ideas, doctors, thoughts, tests / results, all in one convenient post.
Either way, your feedback will be greatly appreciated.
alan86734 vigneron
Posted
Hi, Vigneron, What can I say. "One man's meat can be another man's poison". Fortunately I did not suffer the side effects you describe.
I was treated for asthma despite my protests that I had no history of respiratory problems. My highest dosage of prednizone was 80 mg x 4 per day! Then about 30 years ago I discovered that Singulair potentiated the prednizone and I was able to cut the latter down to 5 mg daily, which is barely therapeutic.
Yesterday (August 16th, 2017) I walked out of my respiratory specialist's office with the official assertion that I was, from the respiratory perspective, a perfectly healthy man. So much for the "incurable asthma", but I am not a doctor. Who knows, you might get lucky and find a beneficial drug interaction.
I wish you the best of luck! Alan.
vigneron alan86734
Posted
Yes, some if perhaps almost most people do not have a problem. but --- there are others, like myself, who have a BIG problem. I can not even use nasal inhalers with steroids such as Nasocort. When I had my problem, doctors said it could not possibly be from Prednisone because the anxiety lasted too long. I was referred to mental health and given some downers which did not help. VA thought I was just having PTSD symptoms for which I was diagnosed (Vietnam Vet). It was only when I looked up side effects that I found that yes, indeed, it can be a major problem for some people. Doctors should AT LEAST inform people of the possible side effects and severe side effects. I was not. I am wondering if perhaps some of the side effects from PAE procedure are in some small part related to Prednisone. In case there are doubters, here is a link on what others have experienced:
http://www.medhelp.org/posts/Anxiety/Anxiety-and-Prednisone--Anyone-PLEASE/show/579342[/b]