Don't Let Prostate Cancer Create a Wedge in Your Relationship

Every month, I hear from men who tell me their marriages ended after they were diagnosed or treated for prostate cancer.

After hearing the same story from dozens of men, I assumed a direct relationship existed between a prostate cancer diagnosis and divorce. I searched for an hour but couldn’t find a study in the United States about the divorce rates among prostate cancer patients. Then I realized I was asking the wrong question. Too many variables exist.

For example:

• Are divorce rates different among men who recover their erectile functioning versus those who don’t?
• Are the divorce rates different among men who recover urinary control versus those who don’t?
• Are the divorce rates different among men who use alcohol or drugs to self-medicate their depression versus those who don’t?

It’s safe to say a prostate cancer diagnosis is stressful for any relationship because it’s inevitable that unwanted changes will occur before, during, or after treatment. Based on my experiences, as well as the input I’ve received from hundreds of couples, few couples are prepared for the way a cancer diagnosis will affect their relationship.

It is possible, and highly desirable, to perform a relational tune-up as you face the realities of living with prostate cancer.

I’m the type of guy who (before any long trips) checks the tire pressure, fluid levels, and maintenance schedule of my car to minimize the chance of a breakdown. If someone suggested the need for a relational tune-up before my biopsy, I’m certain the idea would strike me as common sense advice. But I’m not sure in the midst of coping with all my fears and anxiety I could have pulled it off.

In the middle of coping with the possibility of receiving a prostate cancer diagnosis and the stress associated with thinking about treatment decisions, I suspect I’d find it easy to dismiss the need for a relational tune-up. Looking back, it’s easy and accurate to say it could have saved both my wife and me a lot of unnecessary relational misery and suffering.

Going back to the car analogy: When a car breaks down, some folks have the ability to perform repairs on their own. Other repairs require a professional. When it comes to relational tune-ups, some couples have the skills and ability to do it themselves, while others need professional help.

To determine whether you can do it yourself, following are some questions to help you decide:

• Were both of you happy with the state of your relationship before your cancer diagnosis?
• Do you have a history of successfully coping with highly stressful events or crisis situations together?
• When conflict arises in your relationship, can you resolve the issues without belittling or attacking one another, or using sarcasm, being hostile, blaming, name-calling, or withdrawing from each other?
• As you resolve crises or conflicts in your relationship, do you feel closer to one another?
• Are you successful in resolving sexual issues and problems that occur in your relationship?
• In the midst of conflicts, do you maintain goodwill and positive regard toward your partner?
• Do you feel closer to each other as you deal with crises, stress, and conflict?i
• Is your relationship free from physical, emotional, sexual, alcohol, or drug abuse?
• Does the idea of ending your relationship never occur to you in the middle of conflict, arguments, or unwanted change?
• Does your relationship contain elements of fun, laughter, romance, and a mutually satisfying sex life?
• Do neither of you have a history of divorce?

If you answered yes to all these questions, you have the skills and the ability to attempt a relational tune-up together, without professional intervention.

However, answering yes to every question is not a guarantee you won't need professional help keeping your relationship together at some point in your journey of coping with cancer.

Answering no to one or more of these questions suggests that seeking individual and/or couple's counseling could be a wise choice if your relational goal is to draw closer together rather than allowing the stress of coping with cancer to pull you apart.

I suggest reading a book titled, "The Seven Principles for Making Marriage Work," by John Gottman.

If your efforts at a relationship tune-up bring you closer, you've succeeded.

If at any point in your journey you lose your goodwill toward one another, an overwhelming amount of stress, anger, conflict, fighting, blame, or emotional and physical distance occur, or you lose the capacity to have fun, laugh, and enjoy each other's company, the red light warning sign is flashing and it's time for a professional relationship tune-up. Your cancer treatment center is a starting point for seeking a referral.

Note: This article appeared in Prostate Cancer News Today 

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:

I Left My Prostate in San Francisco-Where's Yours?

provides men and couples with information and support before, during and after prostate surgery.

Their second book was written after the couple dealt with erectile dysfunction for four years following Rick's double nerve sparing surgery. The book was written for men and couples coping with erectile dysfunction. The title of their book is:

Everything You Never Wanted to Know About Erectile Dysfunction and Penile Implants.

Erectile Dysfunction & Penile Implant Surgery

My wife and I lived with erectile dysfunction for four years after my double nerve sparing prostate surgery. In our unique, award winning book, written to help men, women, and couples cope with erectile dysfunction, we also share the renewal, and transformation, of our sex life after penile implant surgery.

Here's what a reader gave me permission to share:

Rick and Brenda. I LOVE THE BOOK. Thank you both so much. This book has immediately changed the dynamic between my wife and I. Brenda's insight and honesty are priceless. You both should feel very blessed and honored to have been used by God to help so many of us. 

Check out our award-winning book 

Everything You Never Wanted to Know About Erectile Dysfunction and Penile Implants. 

Climacturia is a Common Post Prostatectomy Issue

I decided to write this column after an embarrassing and humiliating experience. I was hesitant to go public with this, but I believe far too many men and couples are suffering alone and in silence.

Leaking urine is listed as a possible risk in all of the consent forms for prostate surgery. What isn't listed in most consent forms is a specific type of urine leak called climacturia. This is an uncontrolled leaking of urine during an orgasm. I leak urine before and during an orgasm. Like most men with climacturia, I don't regularly leak urine at other times.

This week, during a sexual encounter with my wife, I managed to wet the sheet with urine during a moment of excitement. It was a large leak. We had to take off the sheet and mattress protector and put it in the wash. I felt like a little child who wet his bed.

In several studies, the rate of climacturia after prostate surgery averages about 30 percent. 

This unpleasant symptom adversely affects sexual satisfaction.

A question that has bothered me for years: Why wasn't this known risk discussed with me before my surgery? 

As far as I can tell, from reading current consent forms seven years after my surgery, it's still a risk hidden from men consenting to prostate surgery.

Since my prostate surgery, I've lived with a waterproof mattress protector. We use a towel as an added measure of protection. I make sure I use the bathroom to empty my bladder before we engage in foreplay.

This isn't terribly romantic. I'm blessed with a very understanding wife who is not turned off by this problem. I'm sure it bothers me more than it bothers her. If I were single, this would be a devastating issue. I'm sure many married couples struggle as well.

I'm surprised that after seven years, I still felt angry as we were changing the sheets. I guess I haven't made peace with the betrayal I experienced when I discovered this was a known surgical risk I was not prepared for. I learned about my climacturia from my own research and personal experience.

I suspect the overwhelming majority of men who consent to prostate surgery are not informed about the risk of climacturia. Why not?

If you are thinking about prostate surgery, discuss the risk of climacturia with your surgeon. Also, discuss treatment options and referrals if you discover you're one of the men who'll live with climacturia after your prostate surgery. Don't allow climacturia to ruin your sex life.

Note: This article appeared in Prostate Cancer News Today 

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:

I Left My Prostate in San Francisco-Where's Yours?

provides men and couples with information and support before, during and after prostate surgery.

Their second book was written after the couple dealt with erectile dysfunction for four years following Rick's double nerve sparing surgery. The book was written for men and couples coping with erectile dysfunction. The title of their book is:

Everything You Never Wanted to Know About Erectile Dysfunction and Penile Implants.

Chronic Pain From Cancer is Dangerous

Three weeks ago, I herniated a disk, which pinched a nerve. I was in constant pain. My narcotic pain meds didn't bring my pain to a level low enough to allow me to fall asleep.

Whether your pain is cancer-related or not, like me, you may find yourself thinking dark thoughts in response to chronic pain. These usually occur in the dead of a sleepless night. Here are a few dangerous options I've considered in the last few nights:

1. Taking more than the prescribed dose

If your prescribed dosage isn't working, it's easy to think taking more will provide better pain relief. According to a post by the American Addiction Centers, "Since 2000, overdose deaths from prescription opioid painkillers have risen dramatically, with more than 14,000 deaths in 2014 attributed to prescription painkiller overdose." Deciding to take more than your prescribed dosage of pain medication can be a fatal decision. Don't take more than prescribed.

2. Mix and match

If you've saved pain medication from a previous illness or injury like I do, the thought of combining your current medication with previous medications is another dangerous temptation. CBS News reported in 2014 that, “In 2013, nearly 60 percent of people using opiate pain medications were taking them along with some other drug in a potentially hazardous combination.” Combining your own medications without medical supervision can cost you your life.

3. Combining alcohol with pain medication

According to an article in Scientific American, painkillers and booze are dangerous to mix because both substances slow breathing and obstruct the cough reflex, which can create a "double-whammy effect" that can suffocate you.

4. Desperate measures

As an intake assessor for a psychiatric facility, I spoke with a woman suffering from frequent and painful migraine headaches. I advised her to come in for an assessment. She stated she wanted to go on a vacation before coming in for her assessment. She gave me a date to call her back. When I called her back, a family member informed me she'd taken her own life. I was devastated.

A cousin of mine had chronic and severe back pain. Nothing they tried provided effective pain relief. One day he got into his car with a gun. He shot and killed himself.

I think the majority of people coping with chronic, severe, sleep-disruptive pain have thought about taking their own lives, at least in passing.

I'd seen my doctor a week after my pain began. She ordered an X-ray (because Medicare denied an MRI), and I was given a prescription muscle relaxer, pain pills, and a referral to physical therapy. One week later, I asked myself the following question: "Can I continue to live with my current level of pain, sleep disruption, and physical limitations?" The answer was no.

The next question was, "So what am I going to do to make this situation more tolerable?" The reality is the medical system doesn't find chronic pain or severe sleep disruption to be medical emergencies. It's possible you can be stuck with that miserable life-altering situation for weeks at a time.

I let my doctor know that my pain level was worse. I needed her to get Medicare to approve an MRI. This was necessary if I needed an epidural injection to effectively treat my pain. She put in the request, and my MRI was approved.

For me, the most important relief I needed was sleep. So, I asked my doctor to prescribe sleep medication that I could take in conjunction with my muscle relaxer and pain medication. It's amazing how much better I felt after a few hours of consecutive sleep.

The good news is that I'm getting adequate sleep. The bad news is my pain level keeps getting worse. I have to wait a week for my next appointment to discuss the results of my MRI. It's more than likely I'll wait a week or more before I see someone who can give me an epidural injection.

The whole process can take a month or more. As I said earlier, chronic pain and sleep disturbance are not considered medical emergencies, until you're the patient. According to a 2017 study, patients with chronic pain are twice as likely to commit suicide.

It's not surprising that, from a patient's perspective, chronic pain and sleep deprivation are emergencies from day one.

Waiting days, weeks, or months for a diagnosis and treatment leads to the temptation to take matters into your own hands. Unfortunately, one mistake can cost you your life. If necessary, ask for a referral to a pain clinic rather than attempt to manage your pain yourself.

Note: This article appeared in Prostate Cancer News Today 

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:

I Left My Prostate in San Francisco-Where's Yours?

provides men and couples with information and support before, during and after prostate surgery.

Their second book was written after the couple dealt with erectile dysfunction for four years following Rick's double nerve sparing surgery. The book was written for men and couples coping with erectile dysfunction. The title of their book is:

Everything You Never Wanted to Know About Erectile Dysfunction and Penile Implants.