u/whatever_pumpkin

I posted before and wanted to give this and other communities an update. You all have been so kind and helpful and encouraging. I thank you profusely.

For the record, mid-50s male with BPH, near 130cc prostate, acute urinary retention got me down this path. I’ve had a Foley cath for over 2 weeks.

After failing a void test and having a new Foley put on about a week ago, I discussed options with my Urologist. He recommended Aquablation, but with a PAE 3 -4 days prior for bleeding control. i explored many options, did a lot of reading, and got comfortable with his treatment plan. A number of other places are using this combo therapy for large prostates. My doc was willing to get me on the fast track, so this week is the week.

I had the PAE done this morning. Honestly, it was pain free and easy. I’ll try to capture the process, because, for me anyway, knowing what to expect helps immensely.

Got to hospital at 8:30 am. Could not eat or drink after midnight the night prior. You have to stop blood thinners (I’m not on any, but doc will tell you this) and I stopped taking my multivitamin in that some ingredients can have a thinning effect.

Taken back to pre-op. The main OR nurse talked to me and got information. Another nurse added an IV and took some blood for a pre-surgery blood test. All looked normal except for potassium which was a little high. She briefed Interventional radiologist and he was not concerned. Then waited about 45 mins for OR to open up.

Taken to the OR (really a cath lab). Scoot over to a long table where the procedure will be done. They use a C-arm CT for imaging, so you aren’t in a Tube like for an MRI or the like. Lots of nurses all of whom were introduced. Lots of prep—shaving of insert sight, a sterile field onset up (so lots of drapes and a surgical blanket, cleaning of insert site, etc.). There is a large screen and a smaller screen the doc uses for navigation. I could not really see it, though I wanted to. They asked for what music I’d like to hear, which was nice.

Doc comes in, music off, everyone verbally agrees on what procedure they are doing. They confirmed the same with me earlier. Then they give me some Versed and a small amount of Fentanyl through the IV. You start to feel like you’re drowsy and they start. To be honest I couldn’t even tell they started. Didn’t really feel the doc numb the area with lidocaine, didn’t know he did the puncture…it all just happened.

I noticed myself snore a couple times.l, so I was in and out for the first prostate artery. In the middle of the second one I became more lucid. No pain, but I could pay attention to what they were saying. The nurse gave me a little more drugs to relax me for the rest of the procedure. At a couple times they had me cross my arms over my chest. I was able to follow instructions with a little assistance given wires, etc. I did feel a little warmth when contrast dye was used. Nothing awful.

Then at the end, I could feel a little form pressure at the entry site as the doc used some closure device. No pain. Just like someone pressing on your thigh a bit. Soon after I was talking with the nurses. They have you stay flat incl neck and head) and use a board to move you to the stretcher. This is to protect the closure at the puncture site.

Then had to wait maybe 1 3/4 hrs in recovery flat on my back. Nurses for me some snacks and water, watches a little TV, got post op instructions and now I’m home. Need to stay horizontal for a day. Can’t shower for 24 hrs. Tylenol if there is pain (if there is any it’s like a “1” on a scale of 1/10).

That’s it. If you’re a good candidate and PAE works for you, or if your situation requires a PAE before Aquablation, I would not hesitate.

Stay tuned for Part 2 with the Aquablation later this week.

Mid 50s male, 129g prostate. Recently had urinary retention issue resulting in a Foley cath for a week. Prior to that, my symptoms weren't great, but they were managed pretty well with Flomax 1x daily. After this episode, doc upped my Flomax to 2x daily, added low dose tadalafil, also finasteride if we decide to try medication management. I failed void trial after 6 days of Cath, inserted a new Foley. It's been another week (so about 13 days total now). Had a urinary infection with the second Cath and took antibiotics for 5 days to knock it out.

I had a surgical consult today. Recommendation is to do a PAE and then a few days later an Aquablation. My understanding is that this helps with bleeding and recover, and potentially helps with a longer lasting outcome. Doctor can get me in for both pretty quickly in the next week or two. He's done over 100 of the Aquablations. I have no idea what interventional radiologist would do the PAE. These guys are all part of a big system in my area. I'm finding out and doing some diligence.

Here's my question for the group. If you were me, would you try a second void trial, at the risk of having to endure another painful Cath insertion if I fail? Or should I just go ahead with the procedure, live with a Cath for a week or so prior, and go from there? Is there any benefit to being on a Cath for the PAE? Also, how much diligence do you do when selecting a doctor? My previous doc left this practice, so the new one is fairly new to me. Decent guy, good educational credentials, reviews, no malpractice suits, etc.

I'm really nervous about all of this. Thanks in advance.

Has anyone had or investigated the TULSA procedure? I guess they use live MRI and ultrasound to safely destroy Prostate tissue. There is a hospital in my area that offers it, so just wondering how it compares to Aquablation and other treatment options. Thanks. https://tulsaprocedure.com/

As title says, I am in my mid-50s. Diagnosed with BPH 3 years ago or so after an episode where I was had urination symptoms. I felt like my nervous system was off — like my brain and bladder were not communicating effectively. Was also changing doses on some antidepressant meds. Resolved with some Flomax short term.

My prostate is a whopping 130cc now and I had a similar experience to before. One day I had to go urgently. The next I was straining and not going at all, to the point where I went to an urgent care, and then my urologist. With lack of urination they put in a Foley catheter for 6 days to protect the kidneys and give the bladder a rest. Upped the Flomax (which I had been on) and added low dose Tadalafil.

Took the catheter out, but completely failed the void trial. Passed very little urine during the 6 hrs after removal. As a result they re inserted a new Foley. I am so disappointed.

My questions for the group: (1) has anyone else experienced this? (2) is it unusual to fail a void trial after a week of catheterization? (3) will an extra week of catheterization give my bladder the rest it may need and/or give meds more time to help? Or am I screwed? (4) do you think I should try drugs like Avodart to reduce size or am I bound for procedural interventions?

Thanks in advance. Just looking for some comfort and guidance. I’m so bummed.

Looking to buy a used set for a teen interested in the game. Perhaps a dumb question, but, how old of an iron set would you consider, given changes in technology?

I know if too old and you risk rusting shafts, decaying grips, etc., but my impression is that the tech and forgiveness improvements are incremental over time. Like 15-20 yr old clubs probably have stronger lofts, less forgiveness, but has tech changed that much over last 5-10 years or so?

Given it’s Father’s Day…I am looking to purchase a used set of clubs for my son, who is interested in taking up the game. I’ve seen “complete sets” of new clubs on Amazon for like $350-400, but I’m thinking I can find a better starter option on the second-hand market.

Any recommendations on clubs that you’d recommend? Or at this point, anything will do? Hoping to spend maybe < $400 (not including bag).

Other question…kid is tall. Like approaching 6’5”. Do I need to find irons with an extra 1/2” or 1” of length?

Thanks in advance.

Relatively new boater here. Question for the group…roughly how much would one expect to pay for insurance and storage for say a nice, 24 ft center console (in a state with some hurricane risk)?

I’m thinking at least $1500 for insurance (watercraft and liability)? And then $400 a month for a high and dry or a slip? Maybe half that for a fenced lot? Curious what people have been seeing.

Can someone explain to me how the grading works the semester before you graduate? Like for this summer, graduation is 7/31-8/1. Professors have grades due 8/5. Do they just calculate grades early for seniors so that they can walk and get their diploma?

Also, are the ceremonies divided up by school or major? So like is the school of business in one spot, arts and sciences in another, etc?

Thanks in advance.

I have had chronic asthma for a long while. It is generally controlled with an inhaler, but in the last year I started having a real wheezing quality any time I coughed. My Pulmonologist did some tests and decided that Tezspire would more than likely help the issue. I have taken one dose. It seems to be helping to a degree...where it has been helping amazingly is with nasal polyps, which have been affecting my sense of smell for years. It's so cool to be able to smell food, wine, perfume, flowers, whatever again!

On to my question -- have any of you used the copay assistance program? Are there any disqualifiers if you have commercial insurance? With my (crappy) insurance, the drug is covered, but my copay is upwards of $2000 per dose. Not sustainable. I'm just hopeful that their copay assistance program helps me.