After your volume study is completed and the results are analyzed, you and your physician will decide on a course of treatment. If brachytherapy (seed implants) is chosen, several things must be done to prepare for your implant procedure. Although in special cases these things can be done in a few days, it is more likely that two or three weeks will elapse before everything is ready for your implant.
- The Radiation Oncologist first confers with a Medical Physicist and writes a prescription to specify the radiation dose to be delivered to your prostate. A treatment plan, using sophisticated computer software, is prepared. The plan is finalized and the radioactive seeds are ordered.
- The seed orders are filled on an individual basis (in fact, the shipping documents we receive have your last name on them). When the seeds are delivered, the Radiation Oncologist and Physicist confirm they are the prescribed activity level. The seeds are then sterilized, and loaded into the brachytherapy needles in precisely the pattern that the treatment plan calls for. Each needle is then carefully arranged in a special box designed for this procedure. The plan and the needles containing the seeds are delivered to Same Day Surgery prior to your arrival in the surgery suite.
Seed Implant Preparation
- You will receive and be instructed to follow bowel preparation procedures prior to your seed implant. It is very important that you strictly adhere to the instructions.
- You will receive a phone call one to two days before the day of the seed implant. The Nurse Coordinator will review and clarify the instructions related to the seed implantation procedure and will address any questions you may have.
- Please note that you will need someone to accompany you to the
facility, be here while you are given discharge instructions, and remain with
you for 24 hours after the procedure. You will not be allowed to
drive a vehicle for 24 hours after your implant due to potential residual
effects from anesthesia. You will be given prescriptions that will need to
be filled so that you may start to take the medications on the day of your
implant.
What to Expect
- On the day of your implant: Arrive at the Dolores Hope Outpatient Center (see campus map) one hour prior to your treatment time. Please check in with the Registrar across from the Surgery Waiting Room on the second floor of the Dolores Hope Outpatient Care Center. The seed implantation procedure will take approximately 60 to 90 minutes. After your procedure you will spend one to two hours in the recovery area. Total time at the Surgery Center will be 3 1/2 to 5 hours.
- In the preoperative suite: You will be asked to change into a
gown. At this time you will sign a consent form for the procedure. A Nurse
will review your current health status and medications with you.
- Vital signs, which include temperature, blood pressure, pulse, and respirations, will be taken. In addition, an intravenous line (I.V.) will be started. Your wife, other family member, or friend may accompany you at this point. Post procedure instructions will be reviewed as well. Finally, the anesthesiologist will review your health history with you and explain the anesthetics to be used. This preoperative period is the best time to discuss any concerns regarding surgery, anesthesia, and outcomes. After you are taken to surgery, your family will be directed to the waiting room. They may wish to get something to eat or simply wait for the doctor to give them a report on your procedure. Your nurse coordinator at the Arnold Palmer Prostate Center will be available to your family at all times during your stay here to answer any questions.
- In the treatment room (operating room)
: Monitoring devices will be
placed on your body and the appropriate anesthetic
will be administered by the Anesthesiologist.
The Radiation Oncologist and your Urologist
work together as a team to perform the seed
implant. The doctors direct the needles that
contain the seeds through the perineum (the
region between the thighs, bounded by the scrotum
and the anus) into the prostate gland under
ultrasound guidance. Once the seeds are implanted
the Urologist will perform a cystoscopy, which
allows the Urologist to look inside the urethra
and bladder. Based on these findings, the doctor
may place a urinary catheter through your penis
into the bladder.
- In the recovery room: When your implant is finished, the Anesthesiologist will awaken you. You will then move yourself or be assisted to a gurney and brought to the recovery room. There you will be monitored and observed until you are fully awake and stable. An ice pack will be applied to the perineum where the needles were placed to minimize discomfort and swelling. Once you are awake, you will be given sips of water. When you are fully awake and stable, you will be assisted to a chair. This is usually about one hour after you arrive in the recovery room. Once you are up in the chair, you will be given liquids to drink, some popsicles and crackers. At this time, your family and friends will be able to join you depending upon the activity in the recovery room. Prior to leaving the center, post implant guidelines and discharge instructions will be explained to you and your family members or friends. Any questions you have will be answered at this time. You will be asked to sign your discharge instructions sheet and indicate that you understand the instructions. This is an important document that will be placed in your permanent medical record. Recovery room stay is usually 1 ½ to 2 hours. It is required that you have a family member or friend drive you home and stay with you overnight.
Before you are discharged, you will have to:
- Drink and tolerate some fluids and food
- Urinate an adequate amount OR go home with a urinary catheter in place. If needed, catheter care instructions will be reviewed with you and a written copy of these instructions will be given to you. A date will be determined by your Urologist for a follow-up visit and, if needed, catheter removal.
- Receive post implant guidelines, discharge instructions, and prescriptions for post implant medications. You will need to start taking these medications on the day of your implant.
- Review radiation safety instructions with a member of our medical team. At this time, you may ask any questions you have about radioactive seeds and safety precautions.
The Day After Surgery
You will return to the Arnold Palmer Prostate Center on the day after surgery for a post-surgical follow-up visit with the Radiation Oncologist. If your surgery is on a Friday, you will have your follow-up scheduled on the following Monday.
Press Ganey Patient Satisfaction Surveys are sent to patients on a random basis. If you receive a survey, please complete it. Your opinion matters to us and is critical to ensuring Five Star Treatment for Everyone®.
|
|
