Who Needs A Bladder?

 June 5 Hip Replacement Surgery

A few days after my hip surgery I peed a huge amount of blood, followed a few days later, more blood.  My surgeon must have beat the crap out of my hip causing internal bleeding.  I stopped taking blood thinners. A week later and for the next two weeks I did urinalysis and microscopic RBC appeared in my blood.

My urologist did a cystoscopy on my bladder and said, "Well, I don't see any - oops! I see a polyp!"  "You've got cancer!"

Friday July 16 Bladder Cancer Surgery

My urologist scraped the polyp out of the lining of my bladder and then gave me a dose of mitomycin (chemotherapy) in my bladder.  This is called the TURBT procedure. He left a catheter in my urethra which drained a mixture of blood and urine down into a bag strapped to my right leg. Every time I made the slightest movement my bladder would spasm causing the most powerful urge to pee which would never produce more than a few ml of pee but be incredibly painful.

That night the pees became excruciating.  I went to the ER around 10 p.m. and was there until 1:30 a.m. Two nurses irrigated my bladder with 50 ml syringe blasts of saline into my urethra probably 20 times.  Each blast of saline was unbelievably painful.  The irrigation produced what looked like a dozen little dark rods (blood clots).  I was fine for about another nine hours before my bladder was again spasaming every 15 minutes.  I drained my blood/urine bag every couple of hours.  

I enjoyed walking around Safeway in shorts with my bag strapped to my calf.

On Monday my urologist (40 minutes late) removed the catheter.  

July 23 Biopsy Results

My tumor is small and does not extend into the bladder wall.  It is, however, high grade.  It is called a Ta 0 stage tumor.

Followup Treatment

The conventional next step in treating bladder cancer is to do immunotherapy using the drug BCG.  BCG is an attenuated tuberculosis bacterium squirted in the bladder to stimulate an immune response to target any remaining cancer cells.  

Problem is there is a nationwide shortage of BCG and Bartlett hospital does not have the expertise to infuse it even if they had it.

Meanwhile my urologist had a nervous breakdown and left Juneau for Oregon.

Since my siblings live in Colorado I decided to seek a new urologist in Colorado who could continue my cancer therapy and offer me a second opinion.

My frequency of urinations and the associated pain was slowly diminishing until August 23 where my urinations were pretty close to pre-surgery

Return of the Pain

August 21 I suddenly had to pee all the time again and each time it was exceedingly painful.  This continued for the next two and half weeks. 

August 25 urinalysis showed microscopic RBC, but no WBC and no bacteria but Family practice prescribed an antibiotic which I took for three days but it did nothing to alleviate the pain or the frequency of peeing.

August 26 I did a FaceTime with urologist Sam Melouk in Boulder.  He said maybe the bladder spasms are the result of the mitomycin.  He also said he thought it would be just fine to do nothing for now and get another cystoscopy end of October and see if any cancer shows up.

September 1 met urologist Stephen Siegel in Boulder.  He said he had BCG and could infuse me with it for six weeks.  Urinalysis that day (revealed two days later) shows RBC and WBC.  I reported to urologist Stephen Siegel the 10 days of frequent urinations and the excruciating pain.  He prescribed a new antibiotic and a bladder relaxer neither seemed to do anything  

September 4 his nurse Christina called and said I did not have UTI and I should stop taking the antibiotic.  She also said I should drink lots of liquids.  I have always known this and it has been a huge failing of mine not doing it.  But that day I began drinking prodigious quantities of liquids and have been drinking such ever since.

I was still experiencing super frequent and super painful urinations.

Beginning September 5 I began passing blood clots about one per day.  They were a 10 on the pain scale.

September 9 I began to have significantly less pain when I peed.  Siegel said he was going to put me on antibiotics.  I said "You already had me on antibiotics and then told me to stop."  He seemed a bit confused.  We took another urine sample.  He told me to call his office on the 11th find out if I should go back on the antibiotics.

September 10.  I feel 100% better about the peeing.  I am convinced the painful urinations were entirely due to my urethra being clogged with blood clots.  I believe I have passed the last one (five total) and now my pees are essentially normal.  Should I take a blood thinner the next time this happens?

Unfortunately, BCG is supposed to generate more frequent and more painful peeing.  I am not excited to go through that again.  

September 11.  I called and they told me I do not have UTI.  I asked them to schedule me for the first immunotherapy.  I am on for Thursday, September 17 10:15 a.m.