The Day of HIFU

It was 3:00 Monday morning when my alarm went off, and the day that I had been dreading for three years was starting.

My arrival time at the hospital was 5:30, and I needed to do all of the normal morning rituals plus perform the bowel preparation for the high-intensity focused ultrasound (HIFU) ablation that I had opted for in response to prostate cancer.

Arriving at the hospital for HIFU

The bowel preparation started the day before, by going on a clear liquids diet. I was to give myself two separate saline enemas. I determined putting a bath towel on the bathroom floor and getting down on all fours, then lowering my chest to rest on the floor, worked well to self-administrate the enemas. This allowed me to use both hands to squeeze the liquid out of the bottle.

We arrived at the surgical center, completed the paperwork, and waited for my name to be called. As we waited, my mind raced back over the past three years since I was first diagnosed with Stage T2c prostate cancer. I thought about the biopsies, the MRIs, the PSA tests, and the multitude of consultations. I had read several articles and asked plenty of questions about the various treatments that were appropriate for me.

Going over the final checks

My name was called; I was still very distracted by the thoughts of my cancer journey. I was having a difficult time understanding the nurse’s simple instructions. We went to the curtained-off cubical for the pre-procedure prep.

The first thing was to put on the hospital gown. Then the nurse did the body temperature, blood pressure, pulse, medications, medical history checks, and started an IV. Then the anesthesiologist came in to go over the entire procedure. But, I was surprised that intubation was required. I was also waiting for one of the nurses to say that it was time to insert the Foley catheter; I was very pleased to find out that this would happen after the anesthesia.

As I waited to go to the operating room, my nervousness diminished and I was ready to get this procedure over. Then two nurses came in and said it was time to go to the dance. I responded that I was dressed for the occasion.

Undergoing the procedure

I scooted off the gurney onto the procedure table, laid on my back, and positioned my anus over the gap in the middle of the table. After sedation, the HIFU probe would be inserted into my anus far enough to position it adjacent to the prostate. After a few more minutes, the anesthesiologist said here we go, placed the mask over my mouth and nose, and said take a deep breath. Lights out!

Waking up in the recovery room after HIFU, I heard the nurse say everything went well. I tried to respond; the pain from the intubation had made my throat sore and I could hardly squeak out a word. The first sensation was that I had to urinate. The nurse said that I was just feeling the catheter and that the urge would go away. The nurse instructed my wife about the use and care of the catheter bags.

It came time to get dressed. I was still foggy, and putting on the tight-fitting adult incontinence underwear was challenging. The instructions were to wear tight underwear; I chose the incontinence pair just in case there was leakage. Which, there was a little urine and blood leakage at first. I knew that I would need the incontinence underwear after the catheter was removed, so why not start right away?

Recovering afterward

We stayed at a hotel a few blocks away from the hospital. My wife guided me up to our room. I was able to walk fairly well but was still foggy. The first thing that I wanted was lunch. After eating, I took a short nap. By about 5:00, I was feeling pretty good, the fog had lifted, and I wanted to get dinner, but not with the catheter bag hanging off my belt.

I went into the bathroom to switch from the large bag to the strap-on-leg bag. I had watched some videos on how to switch and care for the bags and tubing, but doing it for the first time was a real challenge. It took about half an hour to switch bags and clean up the spilled urine. While doing all of this I realized that I didn’t have any swelling of my penis or scrotum, which was a possible side effect.¹ However, I’ve been told that it isn’t painful. After dinner, it was back to bed to finish my day of HIFU ablation.