1. < Prostate Cancer

Going for Tulsa Pro Jan. 7th

Posted by paulcalif @paulcalif, Dec 29, 2024

I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.

I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.

I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.

Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

paulcalif | @paulcalif | Jan 22 9:16am
In reply to @drax45 "I had TULSA in October. Like you, when my catheter was removed my flow was fairly..." + (show)
@drax45

I had TULSA in October. Like you, when my catheter was removed my flow was fairly weak. Prior to the procedure I had been on 10mg of Alfuzosin to help my flow. Post catheter the Dr instead put me on 8mg of Silodosin which seems to have helped. Blood and tissue stopped in about a week, and the flow steadily improved until it was pretty much back to my normal in six or seven weeks, although I still usually can't make it through the night without a trip to the head.

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You're guys are giving me hope, thanks for the replies.

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bjroc | @bjroc | Jan 22 9:33am
In reply to @paulcalif "My doctor prescribed .4mg flomax but told me if my current Terazosin (1mg twice daily) was..." + (show)
@paulcalif

My doctor prescribed .4mg flomax but told me if my current Terazosin (1mg
twice daily) was working, I might not need the Flomax. I took terazosin,
flomax and ibuprofen this morning. Hope it helps. Barely a dribble this
morning. I'm concerned that with the additional trauma from having to
insert a Tulsa prob twice, that recovery may be delayed if not compromised.

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Yeah, that is what I was like after the catheter was removed, take 2 alpha blocker and add ibuprofen trying to pee.... Maybe they also took catheter out too soon. You will have to see if you get by, but they really like taking it out ready or not as they think people want that but last thing you want is it re-inserted. See if what you take works, flomax is the most powerful one, it really made me pee. Terazosin is not too powerful on that in comparison, it helps but just basic. Activity may or not help, I think I went right back to activity like my walking several miles every other day and so on. But I was taking flomax when doing that. Just keep in mind flomax is real helpful at the start but can make you pee too much eventually, and that can make for "mistakes", so getting off it when I could I was glad.

Well it does get better, but one OTC other than ibuprofen you can safely add is boswellia serrata, non steroid anti-inflammatory not connected to any class of drugs and used forever as anti-inflammatory and sometimes sold as frankinsense.

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paulcalif | @paulcalif | Jan 22 10:10am

There were advantages to having a catheter, like being able to sleep through the night. I certainly don't want it back in!
I really appreciate the feedback, thanks

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bobbygene | @bobbygene | Jan 22 12:09pm
In reply to @paulcalif "My doctor prescribed .4mg flomax but told me if my current Terazosin (1mg twice daily) was..." + (show)
@paulcalif

My doctor prescribed .4mg flomax but told me if my current Terazosin (1mg
twice daily) was working, I might not need the Flomax. I took terazosin,
flomax and ibuprofen this morning. Hope it helps. Barely a dribble this
morning. I'm concerned that with the additional trauma from having to
insert a Tulsa prob twice, that recovery may be delayed if not compromised.

Jump to this post

Since my Nov. TULSA treatment my stream has gotten better and now normal. It was weak following treatment for a few weeks but steadily improved. There was occasional blood but nothing drastic.

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paulcalif | @paulcalif | Jan 22 1:15pm

BobbyGene, are you also taking Flomax? I decided to take .8mg today, fingers crossed. I think an eye dropper could flow more liquid than my system today. Luckily, I am able to void my bladder so far, just takes forever. I guess it's to be expected especially since they had to put 2 different probes in me and the extra time I was under anesthesia. You guys are giving me hope!

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pdcar4756 | @pdcar4756 | Jan 23 8:04am

I was on Flomax for one month following my TULSA-PRO procedure. I had a large prostate (100cc) and BPH had significantly reduced my urine stream. The doctor ablated 60% of my prostate in addition to addressing the cancer lesion. 3 months out from the procedure, while I still have some discomfort due to ongoing healing, I'm peeing like a race horse..........exactly like the doctor said I would.

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paulcalif | @paulcalif | Jan 23 8:55am

That's encouraging, and happy for you. As I said, I'm still peeing like an eye dropper. Every time I go I'm afraid that "this time I'm going to be obstructed" but then with pain it dribbles out. I'm taking the shot gun approach now with meds. Flowmax, Terazosin, AZO, ibuprofen. I think part of my problem stems from the catheter where the anchor point was too high, injuring the exit point. If I knew for sure that this temporary, it'd be no big deal, I can take a few more days or even weeks, but I wouldn't want to live the rest of my life like this. You guys that had trouble at first, how bad was it? Hearing you stories of improvement are encouraging.

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2 replies
bjroc | @bjroc | Jan 23 2:03pm
In reply to @paulcalif "That's encouraging, and happy for you. As I said, I'm still peeing like an eye dropper...." + (show)
@paulcalif

That's encouraging, and happy for you. As I said, I'm still peeing like an eye dropper. Every time I go I'm afraid that "this time I'm going to be obstructed" but then with pain it dribbles out. I'm taking the shot gun approach now with meds. Flowmax, Terazosin, AZO, ibuprofen. I think part of my problem stems from the catheter where the anchor point was too high, injuring the exit point. If I knew for sure that this temporary, it'd be no big deal, I can take a few more days or even weeks, but I wouldn't want to live the rest of my life like this. You guys that had trouble at first, how bad was it? Hearing you stories of improvement are encouraging.

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I was pretty much like you, but I had to drive home after catheter out, and home was 22 hour drive. I think that was the hard part, but I learned to stand in a stall and that helped to pee, that rather than sit which seemed to restrict a bit. Maybe it was odd 22 hour drive so use gas station bathroom or fast food bathroom with stalls, go in a stall and then stand and lean forward a bit, perhaps others in these bathrooms were wondering, but it was what I needed and basically no way standing at a urinal would do it for me as you mention it was slow. So just do what you need to do.... I think your catheter was out earlier than mine so you might need another week here, but after I got back from my drive it was not so bad and things improved fairly easily with all the flomax and so on. Not sure on AZO if that would help, I had some in my bag but I never used it. I think Boswellia did help as I got home I had some for when my wife gets joint pain so that and flomax did the job, but again I was further out.

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drax45 | @drax45 | Jan 23 2:17pm
In reply to @paulcalif "That's encouraging, and happy for you. As I said, I'm still peeing like an eye dropper...." + (show)
@paulcalif

That's encouraging, and happy for you. As I said, I'm still peeing like an eye dropper. Every time I go I'm afraid that "this time I'm going to be obstructed" but then with pain it dribbles out. I'm taking the shot gun approach now with meds. Flowmax, Terazosin, AZO, ibuprofen. I think part of my problem stems from the catheter where the anchor point was too high, injuring the exit point. If I knew for sure that this temporary, it'd be no big deal, I can take a few more days or even weeks, but I wouldn't want to live the rest of my life like this. You guys that had trouble at first, how bad was it? Hearing you stories of improvement are encouraging.

Jump to this post

They kept my catheter in for 16 days after the TULSA procedure, so my experience might be different, but I would describe my peeing as a slow flow, not a dribble, and there was never any pain with urination. I'm assuming that, like me, after they removed your catheter they performed an ultrasound to confirm that your bladder was emptying sufficiently.

We made a five day road trip one week after the catheter came out, and the Tesla required more stops than my bladder.

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paulcalif | @paulcalif | Jan 23 2:59pm

The Tesla had to make more stops - lol
My stream is a little better today. Still painful but flow has improved a little. As the Beatles sang, "It's Getting Better All the Time".

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