One year on - continence

I let this blog go and focussed on other things after a while, so thought I'd wrap it up with a couple of posts on the longer term effects after a year.

First off I am healthy. I've had three blood tests this year all showing undetectable levels of PSA. In other words the cancer did not escape the prostate. Physically I am fit and riding regularly, although a little lardy after Xmas! I still get what feels like 'pinching' pains from my surgery scars occasionally (particularly when constipated) but this is apparently to be expected. 

I was carefully riding bikes around 10 weeks after surgery and was back on the dirt after around 3 months. Four months in I was jumping my singlespeed down the local trails. Six months in I came off my bike and skinned my arm, but nothing popped or broke which oddly felt like a win. 

I have not had any significant continence accidents, but my toileting patterns have changed. I bought a batch of disposable pads that I used for my peace of mind for a few months after surgery and also picked up some specialist incontinence underwear from incontinenceproducts.com.au. They stitch pads into Bonds hipsters or boxers on demand so the delivery takes a couple of weeks but is very discrete. They sell two pad thicknesses and I find that the thicker pad  is quite uncomfortable and feels like a pair of padded bike shorts. The thinner pad is still noticable and a touch warm on a hot day but is much more comfortable to wear. I often wear them when I go out on social events. Looking back the thicker pairs won't ever get worn again and I probably was a bit over the top when buying them, but I will sometimes 'double pad' a disposable pad with the thinner Bonds pad for things like long flights or bus journeys.

I also worked hard on bladder training with my physio, who gave me a series of moves that helped both continence and general recovery. It's essentially just developing mental and physical techinques that help with holding off going to the loo for as long as possible but also working on some techniques to get over the 'key in the lock' syndrome (where you hold off succesfully but then release some urine around 10 seconds before you should do). For a while we had a measuring jug in the bathroom and I kept a log of how many times I went to the toilet and what the volumes were (400-600ml is around normal if you're interested). 

Bladders are apparently easily irritated and this can lead to frequent low volume urination as your mind interprets the bladder irritation as a need to empty. The usual irritants are caffeine, spicy food, sparkling drinks and alcohol and as these are basically my main food groups I had to make some changes to my diet for a few months. I also used a Neurotrac TENS device daily for around three months which stimulated a nerve in my leg that was adjacent to the bladder nerves. The idea is that it 'overrides' the signals from the bladder. I'm not sure how effective it was as I couldn't do any comparisons but it was low impact and easy to do at night when watching TV. The TENS unit was a specialist unit that put out a special zapping pattern that not every commercial unit can deliver, but it can also be used for conventional TENS treatments. Unfortunately Neurotrac decided to brand the unit with 'Continence' writ large across the front of it so it would be a little embaressing to pull out in public - why they didn't just brand it the C1 or similar is beyond me. 

At 12 months after surgery I feel like my bladder is pretty much back to normal, but I'm still very aware of my fluid intake & schedule in multiple precautionary toilet breaks before any long trip or meeting. One of my favourite moments of the year was giving an in-person training course and having an attendee interupt me and ask if it was possible to have a toilet break!