Saturday, January 31, 2015

Penile Implant Surgery Tips

Did you ever wish for a re-do button that would allow you to re-do a decision or event knowing what you know today. Even though I'd spent hours on-line researching information on penile implants and reading dozens of threads written by men who've had surgery, I didn't get the information I needed.

I thought I'd make a list of things that I didn't know but wished I had. One week post surgery, if someone offered me a re-do button,  I'd push it without hesitation.

Knowing these ten recommendations would prevent a week of unrelenting pain. I'd have avoided waiting an extra 3-5 weeks to have my implant activated. I would have  reduced the number of weeks I had to stay at home unable to drive a car or go back to work. In other words, this list could save you from unnecessary grief, delays in healing,  and physical pain.

If you are considering a penile implant, allow this blog to replace your wish for a re-do button.

1. Insist your surgeon use a drain-otherwise your scrotum could swell up to the size of a grapefruit
2. Jock straps aren't the right support for everyone. Sometimes they will cause the pain you are trying to avoid. If you decide to use a jock strap make sure it's large enough to give you the scrotum support you need. Not all jock straps are created equal. The wrong strap will cause you serious pain.

3. If your scrotum is too large for comfortable support from the jack strap use a folded towel. Don't let a swollen scrotum just hang down with no support.
4. If compression underwear is comfortable use it. If it hurts go with loose fitting boxers with some form of scrotal support.
5. If non narcotic pain meds are not effective start with a STRONG narcotic pain med or you may suffer from unnecessary pain. It took a week of unrelenting pain before I got an effective pain med.
6. Don't over use ice. You can't decrease the time it take to reduce you swelling, but  it will feel good. No more than 20 minutes at a time. No more than 3-4 times in a day.
7. It takes effort to find a comfortable way to sit in a chair. You'll need some type of support under your scrotum in order to sit without discomfort.

8. Reclining chairs are wonderful. I slept in one for a week

9. If you sleep on your stomach as I do, you may find it necessary to sleep on your back. It was impossible for me to sleep on my back a flat bed. For the first week I slept on a recliner. Then my wife and I purchased a sleep number bed which allowed me to adjust the head and feet. With the head portion up I was able to sleep in bed, on my back.

10, Even with the most comfortable recliner and sleep number bed I could not fall asleep without the use of medication. I had my Doctor order a month supply of sleep medication  Every few days I'd  to go asleep without medication.  The following rule governs my use of medication for sleep: I'm still awake 1 hour past the time I go to bed, I'll take medication for sleep. I've used sleep medication seven out of the last eight nights.

Eight nights  post surgery (with severe scrotum swelling) It's too painful to sleep on my stomach and . I truly hate sleeping on my back, Our reclining chair was a life saver. What brought me back to my bedroom was a very expensive (but worth the price) sleep number bed with adjusting head and foot positioning. I long as my head is raised up by a 45 degree angle or more, with the help of medication, I can sleep well.

Sleep is essential for healing. If you have having difficulty in this area, make sure to discuss this with your Surgeon or your General Physician,  Sleep impacts how you will heal and how you will feel.

Rick Redner & Brenda Redner are the authors of:
I Left My Prostate In San Francisco-Where's Yours? 
Their award wining book was written to help men and couples cope with prostate cancer





Thursday, January 29, 2015

Asking For Help That Never Comes

Anytime we find ourselves in the role of  a patient, whether we like it or not, we find ourselves extremely dependent upon our doctors. In addition, we have some unspoken expectations that are reasonable expectations toward those who are treating us. We can reasonably expect our doctors

1. To evaluate our symptoms and accurately come to a diagnosis
2. To posses the skills to treat our disease or refer us to someone who does
3. To posses the skills to perform a procedure, test or treatment for our specific disease
4. To provide appropriate  after care and pain control
5. To be available by phone in the event of an emergency

If any of these assumptions prove incorrect, we as the patient, may experience something very unpleasant, life altering or life threatening.

This week I went to UCSF for a penile implant. There was no doubt in my mind this was the appropriate form of treatment for my post prostatectomy erectile dysfunction. I had absolute confidence in my surgeon's skill level and ability to perform this procedure.

After three days at home, it became clear that I was experiencing an allergic reaction to my narcotic pain medication. I was experiencing  difficulty breathing, shortness of breath, and an annoying wheeze. When I stopped taking my pain medication all of those symptoms stopped. Unfortunately, so did my relief from pain.

On Wednesday morning I called my surgeon's office. I told them this was an post operative emergency situation. I explained that was unable to tolerate my current pain medication. I asked his nurse to have my surgeon call in a new script as soon as possible. She assured me help was on the way and I believed her.

At 5:15pm I discovered I'd made costly and inaccurate assumption. I believed my surgeon's nurse that help was on the way in the form of a new prescription. I neglected confirm this assumption by calling  my pharmacy BEFORE 5pm.

If I 'd followed up and checked it out rather than believe, I would have discovered that a script was not called in. At  5:15pm. my surgeon's office was closed. Everyone had gone home, leaving me in severe pain without a new prescription. 

My first plan involved calling the office within the first five minutes of their arrival the following morning.  I planned to speak with the Office Manager with righteous indignation. I'd  tell her that I'd just been through 24 hours of unrelenting and excruciating pain because a nurse ignored my  phone call on the previous day.  I'd demand she interrupt whatever my surgeon was doing to get me a new pain medication RIGHT NOW!.

Fortunately, my pain spoke to me, asking a very simple question which demonstrated the foolishness of my plan. Here's the question that changed my planned course of action: Are you prepared to spend a sleepless night in unrelenting pain? My answer to that question was a resounding NO. That meant it was time to do something about my pain right now at 5:20pm.

I found the number for the On-Call Resident. I left a message with the operator. Within ten minutes I speaking to a doctor. I told him what happened. Five minutes later my pharmacy received a phone call for new pain medication. My wife drove to the pharmacy to pick it up. After taking my new pain medication I was able to slept continuously for the six hours. Clearly, calling the On Call Resident led to a much better outcome for me than waiting all night without pain relief.

When I go for my first post operative check which happens to be tomorrow, I'll make a complaint to both the Office Manager & to my surgeon. There's no reason to be mad at him, I doubt he was told that I called. He needs to know that his office staff are not following through with patient care.

Making this complaint doesn't take away or make up for the unnecessary time I spent without pain relief. There's a lesson here for all of us who find ourselves in the role of a patient. We can't assume things will go as planned or we'll receive the appropriate care we need with a single request or phone call.

I learned whenever I need immediate and necessary care, it's foolish to wait until the doctor's office is closed before I check and monitor what is and isn't getting done. I wish this wasn't true, but in the end it's our responsibility to hold our health care providers accountable. Making repeated phone calls in a single day may not be our style, but it is necessary, if we don't want to pay the price of being forgotten.

Rick Redner & Brenda Redner are the authors of:
I Left My Prostate in San Francisco-Where's Yours?  
A book written to help couples cope with prostate cancer, and life without a prostate









Wednesday, January 28, 2015

WestBow's Real Authors Real Impact Campaign Features I Left My Prostate in San Francisco-Where's Your?

Author Solutions Real Authors, Real Impact Campaign
Redner hopes to help men and couples cope with prostate cancer.

BLOOMINGTON, Ind. -- Jan. 26, 2015 -- Author Solutions, LLC, a Penguin Random House company and the world’s leading provider of supported self-publishing services, is featuring Rick Redner, author of the WestBow Press title I Left My Prostate in San Francisco—Where's Yours? through its ongoing Real Authors, Real Impact campaign.

One in seven American men will be diagnosed with prostate cancer in their lifetime. At age 58, Redner went to a routine exam, during which his life was turned upside down when his urologist discovered a suspicious lump on his prostate. Redner recalled the rapid transition in his life—from feeling healthy one moment to discovering he could be facing a life-threatening cancer the next.

“My wife and I found ourselves totally unprepared for so many issues we’d face together,” Redner said. “We decided to use our experiences to give other couples the opportunity to be better prepared than we were.”

Prostate surgery results in both temporary and permanent changes that affect emotional, relational, sexual and spiritual life together as individuals and as a couple. Redner said he and his wife discovered quickly that prostate cancer is not a man’s disease -- it’s a couple’s disease.

“It became evident to us that we were called to write a book to help others cope with prostate cancer and to reach men and couples inside and outside of the United States,” says Redner. “We’ve had the opportunity to share our experiences on radio talk shows, write articles for magazines and host an online, faith-based pre- and post-prostate surgery support forum, which receives thousands of page views per month. We stand in awe at the number of doors that continue to open for us to help others. None of this would have or could have happened if we ignored the call to write our book.”

Redner believes his book has created the opportunity to reach people all over the world through social media and his website. “Men and women from the United Kingdom, Canada, Ireland, Australia, France, India, Mexico, Poland and Romania have visited our online ministries. We touched the lives of tens of thousands of people around the world.”

To learn more about authors self-publishing books to impact the lives of others, please visit http://www.authorsolutions.com/Our-Authors/Making-An-Impact/. Follow@authorsolutions on Twitter and “Like” us at facebook.com/AuthorSolutions for the latest self-publishing news; and visit authorsolutions.com for more information on our supported self-publishing services.

My transformation  from a frightened man newly diagnosed with prostate cancer to a writer, author and speaker was nothing short of amazing to me.

If you wish to purchase my book here's the link: I Left My Prostate in San Francisco-Where's Yours?


Tuesday, January 27, 2015

A Penile Implant Dilemma- To Tell or Not To Tell- An Important Issue to Resolve

As I was working through all the details to take off from work in order to have surgery, I was faced with questions and a natural curiosity about the reason for my surgery. Most of the people who know me are aware that I'm a prostate cancer survivor. Therefore, there was some degree of concern or alarm that my surgery was related to a return of prostate cancer.

I wanted to put people's mind at ease without having to tell anyone "The reason I'm having my surgery is to treat my erectile dysfunction." or "I'm going into surgery for a penile implant."

I decided to answer all inquires in a way that enabled me to maintain my privacy. If someone asked: "What type of surgery are you having? I'd answer: "I'm having a restorative surgery." I was grateful that no one asked me  "What exactly is it that you're getting restored?" I have no idea how I would have answered that question.

After surgery, I discovered a down side to keeping things to yourself.  By keeping the reason for my surgery private I robbed myself of the opportunity to share my joy, concerns, trials or fears pre or post surgery. I will share my deepest fear about the penile implant here with you.

I imagine myself on a romantic getaway with my wife. We have a wonderful sexual encounter. Now it's time to lay peacefully in each others arms. I discover one problem. I can't find the release valve for the implant. Our time in bed is cut short because I need to  locate and drive to the closest Emergency Room. Once I arrive, I'll need to explain that I'm stuck with an bionic erection that won't go down. The only person who could help me is someone who knows where the release valve is located in my scrotum. Since this isn't the  type of medical problem that occurs every day, I suspect they'd need to phone someone  who has the experience to find  find the release valve in my scrotum. I imagine myself sitting in an exam room for hours with an erection, waiting for that one specific person to arrive. Upon their arrival, I'd have to pull my pants down and allow a total stranger to feel my scrotum in order to find and press the release value. This event would humiliate and probably scar me for life.

To prevent my fear from becoming a reality,  my wife is coming with me when I learn to inflate and deflate the implant. If I can't find the release value I want to be certain my wife can.  There's no way I want to suffer that type of humiliation.

If you've made a decision to keep a procedure or surgery private, there are places to go where you can share  your experiences with people who know exactly what you are going through.  On-line you can find forums for every treatment, surgery or procedure. In these forums you can share your their fears and concerns, You can ask questions and get great answers from people further along the journey that you are on.  Since this is a blog about implants, here's a link to an active forum: about penile implants:                 Frank Talk Implant Discussions


If I had the opportunity to go back in time and start again, I'd make the same choice. I don't need to tell friends or family about my erectile dysfunction or my decision to have a penile implant. That said, I think it's important for a man considering an implant have the opportunity to speak with men who made that decision.

After surgery it's great to be contact with men who have helpful and creative tips with regard to dealing with post surgery issues and lots of experience using the implant. My implant surgery isn't something  I want to share with friends and family, but I do believe it's vitally important to reach out to obtain information, support encouragement, advice and help from folks who've traveled further along the road you are traveling.

Monday, January 26, 2015

Everything I Do Is Embarrassing To My Children

As I was shaving and getting myself ready for surgery the following song began to play in my head. It came from the My Fair Lady. The song title is Get Me To The Church On Time. A few of the lyrics were tweaked as I sang this song looking into the mirror while shaving:

I'm gettin' an implant in the morning
Ding, dong, the bells are gonna chime
Pull out the stopper, we'll have a whopper
But get me to Admissions on time

I got to get there in the morning
Spruced up and lookin' in my prime
Girls come and kiss me, say that you'll miss me
But get me to Admissions on time. Be sure to get me to Admission on time.
.
In order to arrive on time, we'd slept in San Francisco.  I didn't want to drive ninety miles in the middle of the night. We had the hotel give us a wake up call at 5am. My admissions appointment was for 6am.  From where we stayed, it would take all of  five minutes to drive to UCSF.

As I thought about getting dressed, I knew within minutes of my arrival I'd be asked to change into a hospital gown. I was wearing very comfortable pajamas and I couldn't think of a single reason why I should change into street clothes. When I shared this plan with my daughter she rolled her eyes and made it clear she'd so embarrassed she wouldn't been seen within a mile of me walking into UCSF in my pajamas. 

I've been a parent for so long that I can't remember a time when I wasn't an embarrassment to at least one my children. In my younger years I felt bad about this. I wanted my kids to see me as cool dude who their friends would admire. Somewhere in the first decade of parenting I gave up on that idea. 

Now, with more than three decades of embarrassing my children  under my belt, I use their embarrassment  as a beacon of light which tells me what I'm about to do is the right thing to do. Once I heard my daughter express her embarrassment,  I was certain that going to the  UCSF Admissions Department in my pajamas was the right thing to do. In my mind's eye, I imagined walking around the hospital in my pajamas (rather than a hospital gown) would make me look like a VIP. 

I thought my idea was so practical, I was genuinely surprised  everyone else who came to the Admissions Office at 6am was wearing their street clothes. I decided then and there I was the only one in the room that had a lick of common sense. After signing a few papers I was led to a room, handed a hospital gown and told to change. I imagined some poor guy in another room  fumbling with his belt in the time it took me to change from my pajamas into my hospital gown.

I don't want to leave you with the impression that I'm a totally heartless parent unconcerned about embarrassing my kids. I was going into surgery for a penile implant.  I didn't want this very personal and private decision to become a source of embarrassment to any of my kids.  Therefore, I told each of  them that I was going to UCSF for a "restorative surgery." Truth be told, I'm extremely embarrassed to discuss the state of my penis or the fact that I'm getting an penile implant with any of my children. I've only discussed this surgery with a handful of friends and family. I've done my best to keep the reason for my surgery private.

The irony of keeping my surgery private in my personal life then sharing my experiences on line with hundreds of people isn't lost on me. In order for me to share my experiences on-line,  it's been necessary  to overcome my embarrassment and desire for privacy. I believe I've been called to help others as I share my experiences with prostate cancer, erectile dysfunction, and now with a penile implant. Sometimes I not only embarrass my children, I'm called to embarrass myself as well. 

If my kids follow my blog or like my Prostate Cancer Facebook Page,  they'll know I've had a penile implant and  I hope they'll understand my calling to share my experiences with complete strangers.

In the end,  I'm not sure whether I'm blessed or cursed with a common sense that runs counter to the general public, but of this I'm certain, I'll always be a source of  embarrassment to at least one of my kids on any given day.

Rick Redner & his wife Brenda are the authors of :
I Left My Prostate in San Francisco-Where's Yours?

Sunday, January 25, 2015

Why I Have A Love-Hate Relationship With Hospitals

Before I begin, I want to say I'm thankful for those who choose to go into the medical profession. I also have the deepest respect and gratitude toward nurses who spend their day in the front lines caring for patients. I don't like hospitals  and every time I stay in one, the list of why I hate hospitals grows.
Here are my new reasons based on my last one day hospital stay for a penile implant.

1. When I was first brought to the post surgical unit I wasn't set up with a call button. I discovered my predicament when I was hit by waves of pain.  I had no way to call for a nurse. Fortunately, I had my cell phone. I called UCSF and asked for the 4th floor nursing desk. When a nurse answered the phone I told her that I was a patient on her floor, what room I was in, and that I needed a nurse to come into my room with pain medication.  I'd hate to think how long I would have waited for help if I hadn't brought my cell phone with me. This incident made me realize just how much I hate feeling so helpless, unable to care for myself and totally dependent on the care of another person.

2. I've had awful experiences with pain control following surgery. Therefore, I make sure to meet with my Surgeon in order to find a mutually agreeable plan for pain control.  When my Surgeon told me the implant is a relatively painless procedure that does not require narcotic medication, alarm bells went off in my head. If he wanted to have me as a patient,  I needed him to know that I needed narcotic pain medication the day of surgery and throughout the night. He agreed. After surgery I wasn't feeling any pain. I was so pleased he'd honored our agreement. For a brief period of time I thought this would be the easiest pain free surgery I'd ever experienced. Little did I know excruciating pain was just around the corner waiting. I have interstitial cystitis. After an hour or more of  irritation from the catheter,  my bladder was going into powerfully painful spasms every few seconds. I was reduced to moaning from this unanticipated source of pain. I realized I neglected to inform my Surgeon that I have Interstitial Cystitis. This meant we had no plan to treat the symptoms of this disease when it appeared after surgery.

3. When you are in the role of the patient, neither the nursing staff or physicians want you to be the one to diagnose yourself or tell them how to treat you. It took me a while to realize this. Once I did, I asked the staff to consult with my Urologist who treated me for interstitial cystitis.Thankfully, I had his phone number in my iPhone, which came in handy earlier in the day. I don't know whether he was called or not. It took the staff approximately four hours to find the right cocktail of medication to quell the most painful bladder spasms I'd experienced in my lifetime. It was a bitter reminder to me that no matter how well I tried to plan things for all contingencies, things won't always go the way you anticipate, before, during or after a surgical procedure.

4. From that point on my pain level was kept under very good control with one exception. At night I began to feel my pain level rise to a very uncomfortable level. I called the nursing staff to my room and asked if something was wrong since my pain was coming back. They checked my medical records. Apparently, I didn't receive a dose of pain medication that was due. We'd gone a few hours past that point, so my pain from the surgery returned.  It was another reminder that I was in the care of a system that was not perfect. Mistakes that cause pain and suffering will occur.

5. My IV bag ran out. The nurse came in to shut the alarm off. I thought she'd changed the bag, but she got busy and never came back. This error was noticed on shift change an hour or two after the bag was empty.Thankfully this wasn't antibiotics or some other vitally important medication.

A short time later I began complaining that I was feeling bloated, and that I had to urinate but couldn't.  I was told this was a normal experience when you have a catheter. After the pain kept intensifying and I kept complaining about feeling bloated, the nurse noticed my catheter bag was empty. I don't know why this happened, but the physician they called decided I was dehydrated. I couldn't help but wonder if that happened because my IV of fluids stopped flowing hours ago.

Feeling bloated and in pain they told me they were going to push additional fluids into me (causing me additional bloating and pain) and then have me walk around the unit. (causing greater levels of pain) I wouldn't have minded any of those plans if I believed they'd work. For me this was another example of how you lose control of your body once you enter a hospital. After they pushed more fluids into me though my IV and had me walk around the unit, I was told me to lay in bed while they continued to push additional fluid into me. They expected my catheter bag to fill up with urine. Unfortunately for me, not a single drop of urine came through the catheter.

Finally I had enough. My pain level was now through the roof. They'd lost my good will and co-operation. I insisted they take a different course of action. They must have called the on call physician   because what they did next required physician approval. A nurse came into my room and pulled out the catheter. Immediately, I went to the bathroom. I was surprised how easily I could urinate. The bloating and pain were now in the past. I felt relief. I was now in control of  how and when I could urinate. Slowly more of my body functions were returning. As I was recovering from surgery I was lessening my dependence on others, machines or medical devices and medication for my care and comfort.

6. Now that I was able to urinate on my own I knew I could be discharged the next day. Since I have a ninety minute drive to get home. I asked for a dose of medication right before I left. I thought that would keep me pain free until I arrived at home. The staff was kind enough to call in all the prescriptions I needed to my pharmacy so they'd be ready to pick up as soon as we arrived at home. We didn't know that a public event was occurring in San Francisco that day. Exits to the City were closed. It took us ninety minutes to get out of San Francisco. By the time we hit the highway, my bladder spasms returned with a vengeance.We had another ninety minutes to drive before we'd get to our local pharmacy.

By the time we arrived home I was bone weary. I hadn't slept in thirty six hours. As a result of  bladder spasms my clothing was soaked with urine. As I stepped into my house to change, my wife went to pick up my medications. I wondered if I'd made the biggest mistake of my life by going into a hospital so far away from home.

I'm now the proud owner of a AMS 700 penile implant. In six weeks I'll find out if this devise works and whether it will restore my sex life. I feel blessed and amazed we have a medical system that has the skill, talent and ability to make procedures like this possible. I feel grateful to my Surgeon, my Anesthesiologist, and all those involved in performing my surgery. I'm also grateful to the entire nursing staff for caring for me, taking my pain seriously and providing me with the outstanding care that enabled me to leave the hospital after a one night stay. That said, I added six more reasons why I hate being a patient in the hospital.

Rick Redner & Brenda Redner are the authors of: I Left My Prostate in San Francisco-Where's Yours?





Thursday, January 22, 2015

Correctly Interpreting The Signs

A few events have happened which led people to advise me these could be signs not to go through with implant surgery. As the lyrics go "Signs, Signs, Everywhere there's signs." (Five Man Electric Band)
Here's a few of those signs:

1. I get a call from UCSF telling me  to get my pre-operative testing complete because I've got surgery date of 1/16/15.  When I called UCSF Urology on  the next day I'm told that I do not have a surgery date and they have no idea when they can give me a surgery date.

2. I called UCSF Ombudsmen to help me obtain a surgery date. The next day I'm given a 1/23/15 surgery date. I feel both grateful and relieved that someone within the system is helping me. He tells me he will call me in days. I never hear from him again.

3. Two days before surgery I receive written pre-surgery instructions which tell me to report to the wrong hospital.

4. After I informed the Nurse about his sending me to the wrong hospital, he sent me an appology, but he never sent me the correct information.

5. I have to send him an E-mail requesting  information about the hospital where I'm scheduled for surgery.

A few people advised me to consider these problems as signs that  I should go to a different facility or cancel the procedure completely. I disagreed with their assessment of the signs and the lyrics to this song Kenny Rogers song came to my mind:
You've got to know when to hold 'em
Know when to fold 'em
Know when to walk away
And know when to run.


The process to obtain my surgery date, and to receive accurate and correct information where to go for surgery was a difficult and mistaken ridden process. Those errors caused unnecessary stress, inconvenience and delay, but they did not undermine the confidence I have in both my Surgeon's skill and UCSF's ability to provide me with outstanding care. I find no valid reason to fold'em,walk away, or run. My surgery for an implant is on tomorrow 1/23/15.

A number of men coping with ED asked me to share my experiences which I plan to do. Here's the thread where I'll be adding information throughout the next few weeks. If you are interested check back every few days for new posts.
My Implant Journey


Rick Redner & Brenda Redner wrote their award winning book to help men and couples cope with cancer to learn more about their book check out this link:
I Left My Prostate in San Francisco-Where's Yours?



Monday, January 19, 2015

Why Men Withdraw From Sex After Prostate Surgery

Many men experience a reduction and/or a loss of their sex drive after their prostate is removed. This reduction can be a result of a variety of reasons such as:
1. Coping with cancer-the emotions of fear and/or anxiety can impact sexual desire.

2. Depression- men often experience post-surgical depression. When men are depressed they don't typically experience depression the same way women do. Women typically become sad. Depressed men are frequently agitated, irritable, and easily angered. They could experience a loss energy and interest in previously enjoyed hobbies and activities. Depression often leads to a noticeable reduction in desire and/or  interest in sex.

3. Losing urinary control- After prostate surgery the majority of men lose the ability to control urination. This lack of control may great impact a man's desire for sex.

4.Climacturia is a medical term describing orgasm-associated incontinence. Few if any men are told it's very possible they will leak and or urinate during their orgasm. For some men and/or women, urinating during an orgasm is either highly embarrassing or a complete sexual turn off, so the couple may avoid sex due to the appearance of climacturia. 

5. The Loss of Ejaculation- After surgery men lose their ability to ejaculate. This can affect the pleasure men feel. Some men will avoid experiencing orgasms because of the sense of loss or sadness they feel after an ejaculation free orgasm. 

6. A change in the quality or intensity or  painful orgasms-For some men there is a significantly reduced intensity of their orgasms so there is a reduction in pleasure. This could serve as a turn off. Some men will experience painful orgasms after surgery, and there is a built in desire to avoid pain.

7. A reduction in penis size-Some men report a noticeable reduction in the size of their penis. This may cause some degree of shame-which will greatly impact a man's interest in sex.

8. Erectile Dysfunction-The majority of men will experience the loss of their ability to experience an erection for a minimum of 18-24 months. The inability to experience an erection can have a devastating impact on a man's libido and desire for all forms of physical contact. 

I don't know why I haven't read this any where else but this seems obvious to me that prior to surgery each man had a number of triggers which could result in an erection. Some of those triggers for an erection were:

1. Sight-Men often get aroused as a result of seeing something that turns them on.
2. Sound- Certain sounds or sex talk can arouse men. There is a whole industry based on the power of sex talk to arouse men
3. Smells- Certain smells can arouse a man to experience an erection
4. Fantasy- Men have the capacity to use their imagination to think about sexual experiences that arouse them, resulting in erection.
5. Words-Some men are aroused by reading about sexual encounters.
6. Touch- Certain forms of touching can create a state of arousal.

After surgery, men lose their capacity to respond with an erection to each and every one of their sexual triggers. There is a powerful emotional reaction to this loss. After surgery, these previously exciting triggers elicit feelings of loss, disappointment, frustration, anger and shame. Couples are unpleasantly surprised when they discover their pre-surgery sexual history is lost to both of them. Unfortunately, very few couples are provided with counseling or help in grieving these losses. Typically men withdraw emotionally and physically from their partners resulting in their relationships becoming highly stressed.

I believe the complete and total loss of sexual exciting triggers leaves couples confused about their sexuality and sexual relationship. I suspect it takes a compete re-wiring of the brain for a man to learn he can be sexually aroused with a flaccid penis. It's challenging for couples to find new ways to enjoy sex post-surgery many couples lose their way. 

To re-claim your sexuality post-surgery takes time, effort, experimentation, and new experiences to re-program your mind and body to experience arousal in completely different ways than you did prior to surgery.  Men must learn how to find pleasure, enjoyment, and orgasms with a flaccid penis, This isn't a simple or easy lesson for a man to learn but it's an essential lesson to learn in order to re-claim and renew sexuality post-surgery. For some men this is a temporary challenge for others it’s permanent.

My wife and I met this challenge and successfully established a new sexual relationship. However our new sexual relationship didn’t take away our desire to resume the closeness and pleasure of sexual intercourse. We made a decision that surprisingly few couples make with regard to treating ED that's unresponsive to medications or injections. 


Four years after my prostate surgery I decided to schedule surgery for a penile implant. If all goes well I'm six or seven weeks away from resuming that part of our sexual relationship.I'm looking forward to a restorative surgery after experiencing a surgery that took so much away.

Rick Redner & his wife Brenda Redner are the authors of: I Left My Prostate in San Francisco-Where's Yours?

Saturday, January 17, 2015

Don't Waste Your Erectile Dysfunction

Receiving a dx of Prostate Cancer was a shock to my emotional, relational, and sexual life. If you're like me, my libido which was at a 10 before my diagnosis dropped down to zero after I received my biopsy results. While surgery cured me of cancer, being cured of cancer didn't bring back my libido.

I was surprised how devastated I was when I could not regain erectile functioning. I felt as though my manhood and usefulness as man was taken away and would not and could not be repaired. Back in the day, kissing or touching my wife could produce an erection. Now there wasn't anything she could say or do that would get a rise from me. My wife felt awful and I felt awful, but we could not comfort one another because I didn't want to think or talk about my impotence. I withdrew emotionally. I carefully avoided all physical contact which only served to remind me of my impotence. 

At my lowest point, I gallantly used what little manhood I had left to inform my wife that I hereby release her from her wedding vow to stay with me in sickness and in health. I told her it was time for her to find a man who could love her in the way she needed to be loved. At the time I thought this was a loving, kind and generous offer.

I was surprised that my wife didn't react with joy and take me up on my magnanimous offer.  Rather than feel released and free to find another man, she was both hurt and angry that I would suggest such a thing to her. What I realize now is my offer to release my wife of our wedding vows was  a very selfish offer. My wife's very presence reminded me of my impotence, shame and loss of manhood. I thought I'd feel better if I were left alone.

How could I forget how much my wife needed to be held, cuddled, touched affectionately and kissed. How could I forget the power of speaking loving and tender words to each other.  Looking back I don't think it was a matter of forgetting, but rather all of these behaviors were bitter reminders to me that I was impotent, so I avoided them like the plague. As a result I suffered alone, my wife suffered alone, and our marriage together suffered.

Fortunately I was blessed with a woman who had a Biblical view of marriage as a covenant that would not and could not be broken. She knew I had no power to release her from the covenant we made together on our wedding day. Therefore, she was ready, willing, and able to fight to keep our relationship alive at a point when I felt useless and dead inside. It took me a few years before I was ready to enlist and join my wife in the battle to restore our relationship.

It wasn't an easy lesson to learn that manhood has little to do with your erectile abilities.  My Lord and Savior Jesus was for me,  the definition of a man's man. He knew how to love others sacrificially. His capacity to love and act like a man was not in the least bit connected to His erectile abilities.

I realized that God was giving me the opportunity through my experiences with erectile dysfunction to learn a new definition of being a man.

Since I was married, I realized the Lord was also providing me with the opportunity to learn more about my sexuality and my wife's sexuality to enable us to enjoy mutually exciting and satisfying sex together that wasn't dependent upon my having an erection. We created a new and satisfying sex life together which was a delightful surprise to me.

My challenge to every man coping with erectile dysfunction is don't give up. Meet the challenge. Find ways to enjoy the sexuality you have left. In addition to finding  new ways to enjoy your sexuality, strengthen your love for one another.

This is the best definition of  love I've ever read. Not one of these characteristics require an erection. If you love your partner like this, they will feel blessed.

Love suffers long and is kind; love does not envy; love does not parade itself, is not puffed up;  does not behave rudely, does not seek its own, is not provoked, thinks no evil;  does not rejoice in iniquity, but rejoices in the truth;  bears all things, believes all things, hopes all things, endures all things. (1 Cor 13:4-8 NKJV)

Rick & Brenda Redner are Co-Authors of the book
I Left My Prostate in San Francisco-Where's Yours?


Friday, January 16, 2015

Pre Surgery Anxiety/Jitters Are Not Created Equal

Pre-Surgery Jitters are real. Most men and women face a range of mild to severe jitters, days or weeks prior to their surgery. Since I'm blessed with a wife who has a wonderful sense of humor, She and I decided to hold a contest to determine which one of us had the longest list of pre-surgery fears.

My wife is an RN and I've had training and experience as a Medical Social Worker. Between the two of us we came up with a very long and impressive list of fears. After reviewing Brenda's list of fears and sharing my own list, I declared that I'd won the contest. Brenda disagreed. She was certain she'd won. We both shared a hearty laugh and we were laughing at our fears! Humor is a wonderful way to cope with fear. Our laughter didn't take away our fears, but it did take away some of the power away from them.


No matter what type of surgery you are facing, it's possible your anxiety or fear can become so debilitating you think about canceling your surgery, even if this would have an adverse effect on your health.

Here are a few of the concerns/fears that most people face no matter what type of surgery you are scheduled for:
*The fear of dying on the operating table.
*The fear of losing control once you are given anesthesia.
*The fear of waking up in the middle of the procedure
*The fear your surgeon will make a mistake or that the surgery won't go well
*The fear of post-operative complications
*The fear of post-operative temporary and/or permanent changes that will occur post-surgery
*The fear of post-operative pain
*The fear of staying in a hospital overnight
*The fear of the unknown, especially if this is your first surgery
*The fear of the known, especially when you've had serious problems after a previous surgery.
*The fear of post-surgery complications, such as an infection or an adverse reaction to a medication
*The fear of failure that surgery won't correct or solve the problem you hope it will.

This list is far from conclusive, but it's certainly long enough and stressful enough to create anxiety, sleep loss, difficulty concentrating, irritability, and ongoing, unwelcome and intrusive thoughts about surgery throughout your waking hours.

I've learned through experience not all pre-surgery jitters are the same. The reason for surgery creates surgery specific jitters.


For example when I had my prostatectomy I was extremely concerned whether they would find cancer outside of my prostate. I was very worried about whether or not I'd have double nerve sparing surgery which could enable me to recover my erectile functioning. Before my prostatectomy I was worried about a potentially life threatening cancer and whether surgery would cure me. My pre-surgery jitters made sense to me.

Four years later I'm facing another surgery. This is not a life threatening situation. In fact it's the opposite of life threatening, it is a restorative and life enhancing surgery. Despite double nerve sparing surgery and penile rehab I did not regain my erectile functioning. Year after year things got worse rather than better, until nothing worked at all. That's when I decided to treat my ED with a penile implant.

Since this is my 5th or 6th surgery in my life time and it's an elective procedure that I want, I expected a jittery/anxiety free pre-surgery experience. That's not what happened. Instead I simply created a new surgery specific list of fears. Some of them are:

* The fear the device will be defective leading to a second surgery to remove it and a third to get a working implant.
* The fear I'll develop a post-surgery infection causing everything related to my first fear to happen.
* The fear a pump placed in my scrotum will cause discomfort causing me to regret this surgery.
* The fear the implant will damage my urethra in such a way I'll need a corrective surgery.
* The fear I won't be able to find the release trigger which will result in very embarrassing and humiliating emergency room visit.
* The fear sex won't be the same and I'll  end up feeling disappointed and discouraged.
* The fear I'll be in the 2% where the pump simply won't work, leaving me with permanent life-long ED.

There's some good stuff keeping me awake as well:
* The anticipatory excitement of making love to my wife- That can't come soon enough for me!
* The excitement of planning a romantic get a way.
* Getting back something that cancer took away.

Combine both these lists together and you have a stressful brew that could easily set the stage for difficulty sleeping. I can regretfully say that's exactly what's happening with me.

I have no solutions, but I am taking positive steps. First I'm addressing the concerns that can be addressed. Issues such as pre and post surgery pain control. Additionally, I've worked to improve my health by using an exercise bike. I bike ten miles a day 6 days per/week. I'm lifting weights 3 days a week. I've lost 5 lbs in the last month. I'm doing all I can to be in top physical condition before going into surgery. I'm also working to manage my expectations so I won't face total devastation if the surgery is not successful.

At night I've stopped eating anything within four hours of going to bed. I avoid alcohol or caffeine. I'm keeping my bed time consistent. I start my night with a minimum dose of sleeping medication. If I'm not asleep in 20-30 minutes I get out of bed to take a full dose. I read for a half hour or so and then I go back to bed.

I've discovered what I read at night matters. If I read about the implant surgery my anxiety increases. If I read my Bible and pray my anxiety is reduced.  Only seven more days until surgery!

Rick Redner & His Wife Brenda Redner are the authors of:
I Left My Prostate in San Francisco-Where's Yours?





Tuesday, January 13, 2015

What To Do About Broken Promises From Your Medical Team

For more than month I expected to have an implant surgery on 1/16/15 at UCSF.  On Jan 8th my surgeon's office called me and told me to keep my appointment with my primary physician scheduled for Jan 9th in order to get all my pre-surgery tests completed. First I went to my Doctor for an EKG and a pre-surgery physical. After that,  I spent hours waiting for in line at lab for my blood tests. Next it was to another location spent in line waiting to get a chest x-ray. I did everything I was asked to do. I cleared my work schedule for two weeks and made hotel reservations for my wife and I to stay in San Francisco the day before and the day after surgery.
 
When I called my surgeon's office on Friday to let them know everything was completed, I was in for the shock of my life. Rather than confirm my 1/16 surgery date they told me that I was never placed on the surgery schedule.  I was on a waiting list. This meant I never had a chance to have surgery on 1/16. But that wasn't the worst news they'd give me. The worst news was their office hadn't the faintest notion when I'd be moved from the waiting list to the surgery list. I couldn't believe what I was hearing. They'd just called me asking me to complete all my pre-surgery tests only to tell me they had no idea what week or month I'd have my surgery. I felt angry, frustrated, betrayed, helpless and powerless. That's a toxic brew of emotions. There was nothing I could do to make them give me a surgery date. Additionally, it was apparent no one in my surgeon's office would be held accountable or face any negative consequences.

It had taken weeks to get insurance approval. It cost me a half a day off from work to get my pre-surgery testing completed and it was all for nothing. I had to cancel my hotel reservation and change my work schedule. If I didn't have surgery in January I knew I'd have to put surgery off until March. That meant I'd be paying expensive out of pocket costs a second time to have my pre-surgery tests and physical re-done. But worse than the out of pocket expenses, the delay meant another two months of coping with ED.

The rational and logical part of me realized this was not a life threatening situation. My health was not threatened by this delay. The only price I'd pay is inconvenience and delay. That didn't take away the stress, frustration and disappointment I felt about my experience with the UCSF Urology Department.

I own a business and I know what it feels like to be robbed. I was surprised I was experiencing similar feelings.  So I asked myself what it was that I felt robbed of. Here's how that question was answered. I was robbed of my trust. I've been  robbed of sleep. I was robbed of my peace and expectations. Worst of all I was robbed of the time I expected to be healed from ED. I had plans to take my wife for a romantic get a way in March. Instead it looked like I'd be spending my time recovering from surgery. Going to UCSF for surgery in March was not my idea of a romantic get-a-way. 

Unfortunately, there was nothing I could do to get back any of those things. Adding to my pain was the fact that no one cared other than my wife and me.  It was an unpleasant reminder of the impersonal nature of our health care system.

After prayer and reflection I took the following 3 steps:
1. I called the Ombudsman at UCSF. I asked for his help to get me a surgery date.
2. I called my Surgeon's Office Manager and asked for her help
3. I sent an e-mail directly to my Surgeon asking for his help to get me on the surgery schedule.
 Within two days I had a new surgery date in January!

Addendum 
What I received my surgery date, I began to praise God.  I immediately recalled the following quote from this blog.  "No one cares other than my wife and me"  This statement was a reflection how I felt at the time, but it was highly inaccurate. I'd left out someone very important in my life who cared a great deal. He's the one who said:
 For I know the thoughts that I think toward you, says the LORD, thoughts of peace and not of evil, to give you a future and a hope.  Then you will call upon Me and go and pray to Me, and I will listen to you. (Jer 29:11-13 NKJV)
and this:
casting all your care upon Him, for He cares for you. (1 Peter 5:7 NKJV)
The Lord of the universe cared a great deal about the struggles I was facing to get my surgery date. He cares about your struggles as well.

Rick Redner & his Wife Brenda are the authors of
I Left My Prostate in San Francisco-Where's Yours?