It was a bit of a struggle with urinary urgency issues, but I made it through my radiation simulation on June 17th and got my three tiny freckle tattoos used for body positioning. The following is basically a data dump to my URO so that he could plan the next investigations into my urgency issue:
"This morning, even though a good scan was acquired for radiation planning with my RO, the simulation was not without urinary issues. I had to fully empty my bladder upon arriving at the cancer center, I had to partially empty my bladder twice while waiting in the exam room and I had to struggle to hold it while the scan was being run. The urgency issue is still there after the completion of the antibiotics for the bladder infection.
Let me back up a little in the day, so that there is some information on activities and food and fluid intake before my simulation appointment. Woke up about 5AM both nervous and excited. Did a couple of sets of PT exercises for core and pelvic floor. Walked the dog about one mile. Ate breakfast: apple danish and a bowl of oatmeal with blueberries and about 4 ounces of milk (NO coffee). Emptied and reloaded the dishwasher. At about 7:15AM, I took my calcium+D3 supplement and my morning celecoxib. I drank about 16 ounces of water to prep my bladder for the simulation. Showered and dressed. Left about 7:45AM to drive my daughter to school and headed from school to the cancer center. While on a street nearing the interstate, my bladder started saying it was full. As instructed by my PT, I did a few gentle stair-step kegels and some belly breathing and it calmed it down for a short while -- this had worked quite well on the flights that I took about a week ago while on a weekend trip to Arizona (padfree the whole time and only very minor leakage once while doing some strenuous yard work). More attempts at calming my bladder as I drove on the interstate and the exit and road to the cancer center. After parking in the garage, I couldn't wait any longer and hurried into the cancer center and used the restroom and fully emptied my bladder. With a glum look on my face, I met my wife in the lobby and we went to sign in at the Radiation desk at about 8:45AM. My wife had a water bottle with her, so I started drinking some to hopefully reprime my bladder -- I estimate that I drank about 12 ounces. We were brought back to an exam room where we reviewed forms and information while waiting for my RO. My bladder was screaming at me once again and the PT exercises could not quiet it for long. When the conversation with my RO finished, she said that I could partially empty my bladder to relieve some pressure, so I used the restroom and did. Still in the exam room and waiting for my turn for scanning, once again my bladder needed partial relief -- at most 10 minutes after the prior time. A nurse/tech eventually came and took me to the CT scan room while my wife went to the waiting area. Laying on the table wasn't bad at first, but then my bladder called once again, especially after the contrast agent was pushed into my urethra. The staff said to try to relax and make it through the scan, since there was less than ten minutes to go. With slow, steady, relaxed breathing (no kegels during a scan) I made it to the end of the procedure. My RO came into the room and said that my bladder looked very full on the scan and wondered if it was emptying completely during urination. After the tattoos, I was immediately escorted to a restroom. With my radiation schedule in hand, we left the cancer center about 10:15AM and as I hugged my wife goodby in the parking lot, I asked with watery eyes, "When will things go smoothly?"
After my May 31 PT appointment, I was walking around with a big smile on my face, since my dribbling was gone and I was easily handling the three hours at my son's baseball games and the trip to Dairy Queen afterwards. All I had to do was anticipate when a movement/action could cause leakage and kegel to prevent it -- I had told my PT that it was working and that I had scheduled my radiation simulation. Since then . . .
I had finished the last of the second month of celecoxib that PA had prescribed and was about a week into being off of it when it seemed that the osteitis pubis symptoms were reappearing and 800mg ibuprofen three times per day wasn't handling it. I consulted my PCP and he wrote a prescription for celecoxib on 6/12 and said that he would like to evaluate me at the end of a month. I let my PT know and she added more core exercises and hit a couple of pelvic floor musculature release points that could help. It's now there just slightly in the background at times, but it hasn't limited my mobility or activity level. I have had some nocturia and been up 3-5 times per night to urinate. You are aware of the bladder infection that you recently diagnosed. Urine flow seems okay, but volume can be quite variable. I experience urgency, but without leakage. I can't think of any other information, but please ask any questions that you may have.
Please let me know if you can help me, since I don't know if I could handle all of the radiation treatment sessions going as roughly as the simulation. My first ART is scheduled for July 1."
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Ultrasound of bladder indicates that it is empty after urination and urine culture comes back negative. Need to look into over-active bladder and/or bladder retraining via timed voiding.
Another Radiation Delay
SRT IGRT/IMRT urinary urgency beginning after 3rd treatment 
Great news, I can stop taking Lupron
Results are in (Update 2/17/23)
Latest CT Scan and Radiation
