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Worried about seriously ill dad (prostate cancer surgery)

4 replies

Squiff70 · 27/06/2022 23:16

My dad is 70 and lives with my mum in another European country. I'm in the UK.

There's a lot to this and I'll try to keep it concise without drip-feeding so please bare with me.

A few weeks ago my dad was diagnosed with prostate cancer. He chose to have surgery to remove the prostate rather than have gruelling radiotherapy. He wanted to wait until now to have the operation for personal reasons.

He had the surgery on Friday and the admission was expected to be in hospital for around 48 hours then he would continue his recovery at home.

Friday night he was very unwell and deteriorated over the weekend. Yesterday (Sunday) they did two kidney scans as from blood tests it looked like he was in kidney failure. They found his bladder was perforated and his abdominal cavity was full of urine. They told him they would operate today under local anaesthetic to drain this urine and (I assume) repair the perforated bladder.

His oxygen saturation this morning was low (89%) and he has been on oxygen and IV antibiotics since. He's had a chest x-ray but we do not know the results of that yet (dad might do, but my mum doesn't and therefore can't relay info to me). He's been very hot with a high temp. I suspect sepsis.

Tonight my mum has said the plan for tomorrow is to insert catheters (plural) under general anaesthetic but didn't know what for or where. He's been warned he will be in hospital for at least another several days and he's frustrated about this.

Two problems complicate this:

My mum is very unwell. She has an autoimmune condition which causes serious neurological symptoms and fainting. It can be extremely serious to the point of being fatal and dad is terrified about mum being left on her own for a long time. She is not allowed to drive and they only moved house a year ago during lockdown and don't know anyone in the neighbourhood who can help. The pharmacy have agreed to deliver her medication and she can order groceries online. She needs to attend lots of medical appointments and has no way to get there - some are at a hospital 90+ minutes away so getting taxis isn't really an option. I don't know yet if patient transport is available to her.

Secondly, I'm nearly 8 months pregnant and have a 2 year old daughter. Obviously I can't fly over to help support my parents, nor can we drive. My partner and daughter don't have passports and if I deliver the baby over there, we can't get him home by car because newborns shouldn't really be in car seats for longer than about half an hour (they lack core strength and 'slumping' in a car seat can restrict their breathing). I feel completely powerless to do anything to help. This pregnancy is very high risk, I now have placenta praevia on top, and am facing a c-section but can't speak the language either.

A further, less serious worry is that the Internet has gone down in my parents' home and my mum can't get it working. She doesn't have much mobile data for communications.

Obviously my main worry is my dad getting out of there alive. I have no idea what's going to happen to him from here. My other concern is for my mum and her own failing health. No other relatives live over there - we're all in the UK. My mum has three siblings and it's possible one could go over but mum doesn't want visitors as she doesn't feel well enough to be a 'good host' (preparing the bedroom, making meals etc). I realise this can be overcome but my mum is pretty resolute!

Please, if anyone has any medical knowledge or ideas on how I might be able to help in some way, please enlighten me!

OP posts:
Babyroobs · 27/06/2022 23:35

I think I would have to be firm with her and insist one of her siblings go over to help. At least they could drive her to hospital appointments and drive her to see your dad.

Squiff70 · 28/06/2022 16:27

Babyroobs · 27/06/2022 23:35

I think I would have to be firm with her and insist one of her siblings go over to help. At least they could drive her to hospital appointments and drive her to see your dad.

Thank you for your reply (and for reading such a long post!). I'd be inclined to agree with you, however my mum has full capacity to make her own decisions and however concerned I am, I cannot force her to have people stay in her home when she doesn't want anyone there.

My dad is still the same. As far as I know he hasn't had the surgery today as they have decided to try something else first (something to do with a balloon catheter and taping it in place?!) but said if that doesn't work he'll have to go back to theatre for a general anaesthetic so they can insert some catheters between the bladder and the urethra, if I'd understood it correctly.

OP posts:
madamy · 28/06/2022 16:44

I'm not a surgical nurse, but I look after prostate cancer patients having radiotherapy so I know a bit!

To remove a prostate, the bladder and urethra need to be separated (as the urethra goes through the prostate) and then sewed back together. So this might have failed, hence the urine leak, or they might have nicked the bladder causing the leak.
I wonder if the catheters under anaesthetic might be nephrostomy tubes. These go into the kidneys and drain the urine into bags outside of the body rather than into the bladder - I guess this might help keep the urine from leaking whilst everything heals inside. They can be reversed, so don't need to be permanent. But it's quite an undetaking (and not terribly comfortable so they might be trying to explore alternatives).
The balloon catheter I'm not sure about! Urinary catheters have a balloon inside to keep them in the bladder but it would be usual to have one of these routinely after a prostatectomy.

Are you in a position to call the ward directly to get any more information (with your dad's permission) so that you might be able to reassure them both at all? Can your mum call her hospital team to let them know what's happening and see if anyone can help with transport, or if any of the appointments can be by telephone etc?

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Squiff70 · 28/06/2022 17:57

madamy · 28/06/2022 16:44

I'm not a surgical nurse, but I look after prostate cancer patients having radiotherapy so I know a bit!

To remove a prostate, the bladder and urethra need to be separated (as the urethra goes through the prostate) and then sewed back together. So this might have failed, hence the urine leak, or they might have nicked the bladder causing the leak.
I wonder if the catheters under anaesthetic might be nephrostomy tubes. These go into the kidneys and drain the urine into bags outside of the body rather than into the bladder - I guess this might help keep the urine from leaking whilst everything heals inside. They can be reversed, so don't need to be permanent. But it's quite an undetaking (and not terribly comfortable so they might be trying to explore alternatives).
The balloon catheter I'm not sure about! Urinary catheters have a balloon inside to keep them in the bladder but it would be usual to have one of these routinely after a prostatectomy.

Are you in a position to call the ward directly to get any more information (with your dad's permission) so that you might be able to reassure them both at all? Can your mum call her hospital team to let them know what's happening and see if anyone can help with transport, or if any of the appointments can be by telephone etc?

Thank you so much for your reply - that's very helpful! As I understood it, the balloon catheter he already had in was blocking urine escaping (I've had catheters myself but I'm struggling to understand the logistics of that!). They tried this procedure today but it didn't work so he's going back to theatre tomorrow. His surgeon had a day off today hence it couldn't be done sooner. Its great to know that this surgery can be reversible, if its the same one. I think it probably is though.

I can't ring the ward because I don't speak the language so all info I have is via my mum on WhatsApp.

I don't know what appointments mum has coming up that she may miss but I'll find out and work with her to find potential solutions.

Thanks again!

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