So it's been three weeks since my operation at the Royal Marsden and overall I've been very pleasantly surprised. I had a limited template RPLND (left side only) via laparoscopic robotic surgery and I must say the speed and ease of my recovery has been incredible!
Rewinding a bit. As we live down on the south coast, my wife and I spent ages trying to work out the logistics of an operation in London coupled with an unknown duration in hospital and not really much idea how I would be feeling when they did eventually let me leave hospital. In the end we opted for dropping the car at a friends house in Hackney and booking accommodation for the first night that was attached to the Royal Marsden so we had a short walk around the corner for the 7am start next day. After that my wife would make her way back to Hackney and stay there until I was able to be released, at which point she would pick me up and drive me home.
That sorted, and following a couple of pints and a nice Italian the evening before (I was allowed to eat before midnight), and another high carb drink in the morning (which was what they called an 'enhanced recovery' plan where they preload you with carbs) we were up bright and early and waiting to have some more bits removed. I eventually went under at about 10am after various chats with nurses, anaesthetists and consultants, and pulling on the latest in the range of support socks - I had graduated to full leg stockings for this one!!
All relatively standard, drips in arm, count to ten and...three hours later I was woken up in recovery. The first thing I remember was my legs were really sore, forget about the pain from the wounds. My legs were agony, the nurse suggested I try to move them about, so I spent the next half hour (or what seemed like it) flexing my legs. This gradually worked and they started to feel better. I think the leg pain was because I was laid on my side for the operation, a long time to be in an awkward position!
i was attached to all sorts of tubes I didn't have when I was put under...one of which was under my left wrist, but this had fortunately already been removed, I remember having the biggest bruise from this for a good few weeks afterwards - not sure what it was but glad they dealt with that before I woke up! Anyway, the nurse requested that I have on demand pain relief - I was given a lit green button to press when I was in pain - think she said it was pethadine?? May be wrong, a morphine derivative I imagine? This was really useful. I was then taken to the ward to recover.
It was pretty incredible as I felt really good really quickly, I ate too much that day which made me feel bloated. I had four wounds running down the middle of my abdomen...two just above my belly button in the middle, one slightly to the left and below these, and another just below and to the left of my belly button. Each wound was about 10mm, with the exception of one that was slight larger at maybe 20-30mm? Each wound had a waterproof plaster on it that measured around 4cm square. Although the wounds were uncomfortable, by far the worst pain I had in the first 24 hours was from gas. Apparently they inflate your abdomen during the operation to give them more room, this started to cause me real pain. My in demand paid relief dealt with that initially, but this was removed on the morning of the next day. After that, the gas gave me real serious pain that started just under my rib cage and transferred up to my left and then both shoulders.
The nurses kept throwing different pain killers at me, but nothing touched it. They finally said that the only way to get rid of It was to mobilise. But at that point I was still attached to the saline drip and catheter (ugh). So, bag of pee in hand I was walked up and down the ward in order to relieve some of the gas I had trapped. It kind of worked, although I was nervous of burping too hard due to the wounds in my stomach!!
Next worst thing after the wind, was the removal of the catheter. I was glad they left putting that in until I had been under, but I ha d been dreading the inevitable removal. I was right to! Most uncomfortable and painful thing. Not sure if the nurse was a little heavy handed with me or not, but it wasn't nice!!
Anyway, they were originally talking about letting me leave that day (which was the day after the operation), but on reflection, as I was still in pain from the wind, they kept me in until the following morning. So that was it, in on Monday morning, and by Wednesday morning I self-propelled myself out of there!! Straight into waiting car, and a couple of hours later I as back home.
About a week or so later, Dr Maher phoned me at home and told me that they had biopsied the lymph that had the tumour and it was seminoma as expected (and slightly smaller than expected at between 2.5-3cm), they had also biopsied each of the 22 other lymph nodes they had removed during surgery and they all came back negative for seminoma. Yay!! As a result, I have been referred back to the Royal Sussex County hospital for one or two doses or carboplatin to mop up any stray cells, and that should be the end of it hopefully!
Of course the other option would have been the full BEP which I was worried about, so good news all round. I celebrated momentarily until I then started to worry about the treatment!! Just want to get it done now.
I had a total of two weeks off work for the procedure and by the third week I am feeling like I am almost back to normal again. Oh, forgot to mention that when I left hospital I was given 26 single syringes of an anti-coagulant that had to be administered daily to ensure no blood clots etc. these daily injections are getting a bit annoying now, but almost done them - only five to go!! Fortunately my wife isn't squeamish about these things, so doesn't mind doing the deed. I did have to do one myself which took a little bit of psyching up time - something I won't forget in a hurry, but imagine something you would get used to doing pretty quickly. Lack of ability to clot obviously means it's best to avoid bleeding, so to be safe i have avoided flying down hills on my mountain bike for the time being. Frustrating at this time of year, but best to be safe.
Next step? Meeting with oncologist on 1 July to discuss treatment plans etc.
I have to say at this point, a huge thank you to my beautiful wife who has been through all of this at my side and has been unstoppable. Driving 4.5 hours through London and back home, staying in a strange place while I was in hospital, travelling across London on her own to visit me every day, sitting and saying nothing for hours on end while I recover. Buying me the superb Fortnum and Mason scotch eggs (runny yolks - highly recommended). I honestly can't thank her enough, she's been super human and, needless to say, her presence and support have made this whole thing bearable. Additional thanks to Ben and Hannah - old friends who accommodated my wife at relatively short notice.
