All posts by Richard

One Week Post Op: Enlarged Prostate Surgery – Nordic Skiing!

Yesterday was Tour Duluth. If anyone had told me that I would be able to ski 37.5 kilometers (23+ miles) one week after getting out of the hospital after Green Laser enlarged prostate surgery,  I would have told them they were crazy. Even my doctor had warned me … no lifting of anything over five pounds for the first week, and don't work out for a few weeks. While surgeries and recovery times will be different for everyone, yesterday's ski was actually my third time out this week. My first time on the trails was Wednesday afternoon. Apparently my wife and children actually had an active betting pool on when I would break doctor's orders and ski (see "a friendly bet" via my wife's blog)!

Quite frankly, I've been amazed with this process / surgery. Even though my own Green Laser surgery was a bit more severe, as it actually necessitated some cutting in additional to laser removal of some of my prostate, and this landed me in the hospital for an overnight stay (not the norm), the recovery has been very quick. Here are my own words (see earlier blog post) on the pain I experienced the first two days after getting out of the hospital:

"Right now I feel amazingly strong all things considered. I am taking some Tylenol for the pain, and have a burning sensation when I pass urine. Yesterday (post op day 1), the pain was more severe and accompanied by some mild nausea, but even this discomfort ended within ten minutes of going to the bathroom. This morning, the burning pain upon urination is much less severe. Pain of this nature is to be expected. Urine is acidic, and my urinary tract is inflamed right now."

Eight days later, there is just a minor sensation when I have to retreat to the bathroom! (not pain). I see my urologist this coming Thursday, and assuming a full bill of health, it may even be time to restart certain recreational activities with my wife. Everything seems to work!

I decided to blog about this medical procesure just BECAUSE it is so intensely personal for us guys. It seems to stike at what makes us a man. I personally learned that I was foolish in my thinking. One adjusts and moves on. While I realize that many men will have much harder ordeals, it's not worth playing around with one's health. When I started this series of blog posts, the road ahead was uncertain, and my initial problems were so severe such that I ended up in an ambulance being taken to the emergeny room. In closing, I offer thanks to my great medical care (Dr. Dean Tortorelis and staff). God and my family have also been a true blessing during this ordeal. 

You may also wish to learn about Dash for Dads. This event is held through the United States. Anyone can run or walk five kilometers! Support your Dad and learn about prostate cancer. Thankfully cancer was not in the cards for me, but given my Dad, my Uncle, and one of my brothers all have prostate cancer, this was a high probability. Given my genetic predisposition, I will have to watch out for this disease the rest of my life.

Post Update on March 16th: My urologist appointment went fine. Everything checks out well, and I am now just scheduled for a normal follow-up visit in three months. I've even restarted the "recreational activities".

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Posts in this series:

  1. Postate Problems and Nordic Skiing (trip by ambulance to the emergency room)
  2. Prostate Problems and Nordic Ski Racing: Part 2 (compete with a catheter)
  3. Post Op: 2 Days After Surgery (surgery ends up a bit more severe than expected)
  4. Post Op: 1 Week Later – Nordic Skiing! (this post)
  5. Post Op: 4 Weeks Later – Cycling!

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(click to maximize either image: starting out … 17k of 33.k complete)

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Post Op – Day 2 After Enlarged Prostate Surgery … a amateur athelete’s story

Eight days ago I skied the American Birkebeiner … 33.5 miles of kicking and gliding through the forests of northwestern Wisconsin … now I'm resting after my enlarged prostate surgery which took place two days ago. My procedure used laser technology, and did not require an incision. You may read my earlier posts that describe my learning to deal with the events leading up to this surgery, including a trip by ambulance to the emergency room (part 1 | part 2). However, now my focus is on recovery. I have questions in my mind which any man might have:

  • How much pain will I experience?
  • Will my life return to normal … hopefully a better normal?
  • How long will it be before I am able to take long distance skis and bike tours?

Given my "Green Laser Surgery" also included actual cutting with a microscopic knife which is attached to the laser equipment, my body experienced more stress than might be typical from this procedure. Thus, my doctor decided to have me stay in the hospital overnight. While everyone's surgery will be different, here are my recollections of the event:

  • Once they gave me a sedative, I did not even remember leaving the pre-op room to receive anesthesia. 
  • Apparently I did talk with my doctor in post-op. I have zero recollection of any conversation.
  • I vaguely remember feeling a extremely strong burning pain in my urinary tract while waking up in post op, and asking for additional pain medication. My next memory was being in the secondary post op room (i.e. the location where you continue to recover, and family may now visit you)
  • I actually gained 6 pounds in the hospital … all fluid. During my overnight stay I was hooked up and receiving intravenous fluids. This pumped the fluid level up in my body, and allowed the hospital staff to monitor how my new plumbing was working. Basically before I left the hospital the staff wanted to insure I had minimal bleeding, and was able to urinate on my own (i.e. catheter removed).

Basically, I lost 4 hours of my life. About 5 to 10 minutes after waking up in the second post-op room (not in the immediate post-op), my wife was allowed in to visit me.  In the days and weeks ahead I will blog about how fast I recover and am able to start serious physical training, both cross-country skiing (if any snow is left) and long distance bicycling. Right now I feel amazingly strong all things considered. I am taking some Tylenol for the pain, and have a burning sensation when I pass urine. Yesterday (post op day 1), the pain was more severe and accompanied by some mild nausea, but even this discomfort ended within ten minutes of going to the bathroom. This morning, the burning pain upon urination is much less severe. Pain of this nature is to be expected. Urine is acidic, and my urinary tract is inflamed right now. 

Overall given how I feel, I am very optimistic about the recovery process. My doctor does not want me doing to much … I would like to ski soon! We'll see. However, I very much want to thank my urologist and surgeon, Dr. Dean Tortorelis. He gave me permission to include his name in this post. Throughout this procedure Dr. Tororelis has been fantastic in terms of his medical ability, but also insuring both my wife and I knew the benefits, possible risks and complications of Green Laser Surgery.

In closing, here is a photo taken by my wife prior to my going into surgery. I originally said no to the "photo op", but given my daughter had texted my wife Molly and asked for a photo so she could see her Dad … how could I say "no" to Karen!

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Posts in this series:

  1. Postate Problems and Nordic Skiing (trip by ambulance to the emergency room)
  2. Prostate Problems and Nordic Ski Racing: Part 2 (competing with a catheter)
  3. Post Op: 2 Days After Surgery (this post)
  4. Post Op: 1 Week Later – Nordic Skiing! (amazing recovery)
  5. Post Op: 4 Weeks Later – Cycling

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Engaging your Customers via Social Media

Over the past several years, friends and colleagues often have asked me … does your operation have a Facebook site? While a presence on Facebook may be important, better questions are:

  • Who are my customers?
  • Where might they may "hang out" online
  • When my customers are online, is their frame of mind focused towards leisure or work?

The theme of these questions are … unless you understand your customer, the "knee jerk" reaction to spend resources and create a Facebook site may be an unsound business decision. With respect to my personal Facebook usage, I limit that experience to "friends and family". This means Facebook has a "leisure time" focus for me. If your customers are similar, it does not make much sense to create a business focused Facebook site with which your customer may not be very inclined to interact.

Let me explain it another way … not many aircraft engines are sold via Facebook, but for a business with a "leisure time" focus like Betty's Pies on the Northshore of Lake Superior, Facebook is a good investment. Although most of you have never seen the wilderness beauty of the the Lake Superior's northshore, many of Betty's Pie's customers are from the Minneapolis / St. Paul metro region 225 miles to the south. These customers think "vacation" and "leisure" in terms of Lake Superior and Betty's Pies. Thus, a Facebook site is logical, and your customers / Facebook users may be favorably inclined to interact and help market your business.

What if your company is more like the jet engine example? If your customers are more industrial in nature (i.e. your products and their usage of same), it is not likely that a large investment in Facebook will make sense. Given this scanario, one's focus should turn to LinkedIn. 

In a recent study published by the University of Massachusetts, the top 500 companies as represented by Inc Magazine now invest more heavily in LinkedIn rather than Facebook.

Here are two quotes from the study:

  • LinkedIn leads the way. The platform most utilized by the 2012 Inc. 500 is LinkedIn with 81% of companies using it. It has replaced Facebook as the tool of choice for these fast growing companies. The use of Facebook has dropped 7% in the past year while both LinkedIn and Twitter have gained users. In 2011, Facebook was being used by 74% of the Inc. 500 and Twitter by 64%. In 2012, 67% of the Inc. 500 used each of them. 28% are now using Foursquare and 18% use Pinterest. 

The other comment which jumped out at me was the increasing use of blogs. Obviously I've invested heavily in NorthStarNerd.org over the years. Blogs give one the opportunity to reach out with a more in depth commentary where you control the message. Like any of these tools, any resource should be part of an overall strategy.

  • Blogging jumps among the Inc. 500. Thirty-seven percent of the 2011 Inc. 500 had a corporate blog. In this new 2012 study, the use of blogging jumped to 44%, increasing by 7% after remaining stagnant for years. Sixty-three percent of CEO’s report contributing to content as this mature tool enjoys a bit of a resurgence. 

You may be intersted in reviewing some of my own LinkedIn research published over the past five years

In closing, here is a graphic from the study. The same questions which have always driven good marketing and sales efforts still hold. You need to understand the needs, desires and actions of your customers. Your social media strategy should reflect that understanding.

Click to maximize the graphic and view at full resolution.

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2013 American Birkebeiner GoPro Photos

I joined 8,121 of my best friends and skied the 2013 Birkie yesterday. There were four races, and I competed in the 54 kilometer Birkie Classic (33.5 miles), which is the longest race. During the race I wore my GoPro camera mounted on my back and took timed photographs every 30 seconds. Here are the best of those photos. Some of the initial photos have snow smudges on them. I was tripped up by another skier during the mass start. Thankfully another skier called me over and cleaned my lens, and the residual snow eventually melted off from my body heat.

Here are a few photos which give you an idea of what it's like to ski this event. I finished the 54 kilometers in 4 hours and 49 minutes. Considering I've been dealing with a medical condition and was in the hospital emergency room just a little over one week ago, and only received the green light to race on Thursday … for a man just shy of his 57th birthday I'm thrilled with my results (learn more about my personal ordeal).

Click upon any image to view at full size and resolution. In general these photos are of Classic Wave 3, and after the two trails merge later in the race, also include Skate Waves 4 and 5. Conditions were slow yesterday due to the seven inches of new snow that had just fallen within the past 24 hours. However, the new snow made for a Winter Wonderland!

The Start

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Early Kilometers and an Early Aide Station

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Birkie Warrior and the Classic Only Trail

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Another Aide Station and Snow Laden Pines

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Bitch Hill had a curvaceous leprechaun at the summit to greet the skiers!

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The finish on Main Street in Hayward!

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Our Birkie! (left to right)

Me, Molly (my wife), Erik (my son), Pastor Greg: Everyone else but me did the 50k skate, while I skied the 54k classic. Congrats to Erik and Pastor Greg on their first Birkies!

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Prostate Problems and Nordic Ski Racing (part 2)

This post continues my documentation of  how one man is dealing with an enlarged prostate. In my case, I am very active and in the midst of my Nordic Ski racing season. Suddenly being faced with an enlarged prostate which requires surgery was not part of my original training schedule. Today's post will focus more on some of medical issues one must face. As noted in my first post (read for background), we men don't tend to be very good about discussing medical issues, let alone our prostates … a very personal part of our body.

One final comment before getting to the heart of this post, I will use "soft language" to describe certain parts of the body. While not a prude, I do not want the automatic search engine spiders to pick up on certain words / body parts and make the mistaken assumption that this web content should be blocked (i.e. not family friendly). Now on to the medical part of this entry …

On Tuesday I had a renal ultrasound, which thankfully confirmed I did NOT have any kidney damage resulting from my episode last week. When your enlarged prostate blocks normal urine flow, things back up into your bladder. If you bladder becomes full, your kidneys act as an overflow outlet. You will have some indication that you are experiencing the same problem if in addition to pain in your lower left abdomen, you also experience pain in your lower back … essentially the location of your kidneys. Get to a doctor immediately if this happens to you. Don't wait. While your kidneys normal function is to eliminate waste from your body, a backflow is dangerous, and over a period of time your kidneys might be damaged. While an enlarged prostate can be taken care of via various medical treatments, damaged kidneys are another matter. Get help!

Yesterday, I saw my urologist for the second time. It had been one week since my first visit. As you would expect, wearing a catheter for 8 days was not fun. My ego and pride, which should NOT be an issue with this problem, were hurt. This emotion was dumb on my part. The first part of my doctor's appointment was a general consultation outlining what would be our plan for the next two hours. However, both my doctor and nurse were thrilled I had raced over the weekend in a cross-country ski race, and complemented me on how I adjusted to the catheter (i.e. an initial ski earlier in the week when I tested how to keep my tubes and bag in their proper place, followed by a trip to the pharmacy to get some self adhesive ace bandages to keep everything on the inside of my leg).

Now came the medical procedures, which were not pleasant. After your "private parts" are numbed up on the inside, your urologist will use a fancy scope that allows your doctor to see inside your urethra. In my case, the blockage was obvious. The second part of the examination was to fill my bladder with fluid and determine if I could successfully void the liquid out of my system. This was painful, but necessary. The same scope the doctor uses to look inside you, has intakes that allow sterile solution to be slowly forced into your bladder via a syringe.

Once this is done, and things are pulled out, I was left on my own for five minutes and given the chance to try and void the liquid. In my case, only about 1/3 of the liquid came out. While I could understand this intellectually, it became much more obvious and dramatic later in the examination. The key point was I needed surgery to increase the size of my urinary tract. I will be undergoing Green Laser surgery in one week. This surgery is less invasive than what men had to experience in the past, and does not involve any incision.

Previously I mentioned that I understood intellectually that I was not able to pass all the fluid injected into my body, but as with everything … a picture is worth a thousand words. Thankfully, I will not have a catheter for the next week leading up to my surgery. However, the dangerous blockage which landed me in the emergency room can not be repeated. Thus, I was taught to self catheterize myself. This procedure is surprisingly easy and quick. One is given a three foot long very narrow tube upon which one puts lubricating jelly. Very slowly one inserts the tube into one's private parts and pushes it deeper into your body … past my prostate where I could actually feel the resistance / blockage. What was amazing, once the catheter reached my bladder, whoosh! Urine came out with a rush. All of this fluid was blocked and would have eventually backed up into my kidneys resulting in the same dangerous event and pain. Within a few minutes I completed the procedure and withdrew the catheter. Hopefully, this is a process I will only have to perform once per day. That is the expectation. I am also on some medication which helps me pass urine more easily.

The final part of my examination was the consultation. I invited my wife into the doctor's office, and we all discussed my enlarged prostate, and what is involved with green laser surgery. If you have a wife or significant other, I very much recommend making that person part of the decision. It just makes everything easier if the medical treatment and risks are understood by everyone before your operation.

Tomorrow it's off to ski the Birkebeiner which is America's longest cross-country ski marathon. I will be sking in the 54 kilometer classic race, which is about 33.5 miles. Between the various races, there will be 10,000 racers competing. Over the past seven days I've kept up my training, and even competed in the Book Across the Bay race. Thankfully, for tomorrow's race I will be NOT wearing a catheter. However, over the past week I learned how to adjust. If you are an athelete, here are some practical recommendations for competing with a catheter:

  • First … you CAN compete!
  • Second … you don't need a last minute trip to the bathroom! 🙂
  • Third … don't wear underwear or a supporter … better to let your tube swing more freely
  • Fourth … immobolize your tube on the inside of your leg
    • Use self adhesive ace athletic bandages with some athletic tape
    • By keeping everything on the inside of your leg, you can't fall on anything and cause problems … it's physically impossible unless you somehow are able to turn your legs inside out!
  • Fifth … get some neosporin antibiotic ointment. Put this on the tip of your private part. In addition to helping you resist infection, it helps with chafing. It's worth using this ointment all the time … not just while competing.

Here are three photos from last Saturday's race. One competes at night while skiing across the frozen ice of Lake Superior. Luminaria light the trail every 50 meters, with bonfires each kilometer. Molly and I actually skied the course backwards arriving at the start just 10 minutes before the start. Given the temperature was only 3F, this timing was perfect. Before we knew it the sun had set, and the race was on and we were heading back across Chequamegon Bay.

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Posts in this series:

  1. Postate Problems and Nordic Skiing (trip by ambulance to the emergency room)
  2. Prostate Problems and Nordic Ski Racing: Part 2 (this post)
  3. Post Op: 2 Days After Surgery (surgery ends up a bit more severe than expected)
  4. Post Op: 1 Week Later – Nordic Skiing! (amazing recovery)
  5. Post Op: 4 Weeks Later – Cycling!

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Photos: Skiing Over Before the Race!
(click to maximize any image and view at full size) 

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Using my GoPro at the start and just afterwords …

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Yours truly at the start of Book Across the Bay. I'm the second classic skier … wearing the partial yellow jacket. My thanks to photographer Kelly Randolph who took this image and was gracious enough to give me a copy.

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