I heard at the end of April 2002 from my urologist that I have bladder-cancer. Until this point, I didn't know that there is this illness at all. My urologist told me quite bluntly after a Sonografie (ultrasound-examination) that he had discovered a blain in my bladder. He also told me that all blains are cancer or carcinomas in the bladder. 80 per cent of those are benign, however, that is, they are well to therapy. Nevertheless, I was smashed troubled and mental. I admittedly had my family, was as paralyzed, however, and o­nly saw everything negatively, which had to do with the disease.


Thoughts like, maybe I must die, or what, if I to late went to the doctor, earned more and more space in my near future. I admittedly didn't crawl away, tried to continue my life normally, but the disease always was there and I constantly thought of it.


The first OP date then was in the next week. In the Humboldt-clinic, a TUR (transurethral resection) was executed. From the urethra from, the cancer was taken away piece for piece. The taken out tissue-parts then were subjected a histological examination in order to have clear pathological results.


My results were a pT1-G3 tumor at that time.


As the chief doctor explained this result to me, I collapsed. It added o­n top of this that the funeral had taken place o­n this day for my brother. He was deceased at a heavy and lengthy disease with 50 years. I was sent to the convalescence of the bladder from the doctor home for 4 weeks.


I rode my motorcycle to the clinic and so I also returned. o­n half route, the motor failed. I immediately knew which it was. The gas was finished. I had thought that it still is enough. Therefore, I pushed the machine o­ne kilometre wide, as far as to the nearest gas station. I smiled, because of this misfortune. After filling up, I drove another small detour over the fields of Lübars until I arrived finally at home. I told my family the bad results and that I must go to a TUR into the hospital o­nce again in four weeks. I explained my results, pT1-G3:

P = pathological results

T1 = superficial tumor

G3 = most aggressive cancer-type

I told that with the 2. TUR the entire bladder after further tumors and changes is scanned and o­ne wants to see whether the tumor was taken away remaining, or still another treatment necessary would become. Also a complete distance of the bladder could be possible. I appeased them that it would come so badly with me definitely not, because I saw their concerned faces. Myself, I had fear of the next results.


My urologist wrote me farther sick. As far as to the next OP-date, to which he immediately announced me. He thought, we wait for the result of the TUR and possibly then begin with a BCG-treatment. BCG are adapted Tuberculus- bacteria, that introduced into the bladder locally, o­nly there works, and the immune system strengthens and the cancer-cells are destroyed so. This treatment lasts o­ne to three years. In this time, bladder-reflections are performed to the control every three months. He didn't want to know anything for the moment about the possibility, that I could lose the bladder.


I was down calmed at first. Nevertheless, I looked at some articles about bladder-cancer in the internet. However, I avoided the positions, where was written about a distance of the bladder. I didn't want to let myself influenced negatively. Today I know, that I had ousted this topic initially, wanted to let get close.


After approximately two weeks, also the quietest pain had passed at the urination. However, I observed every time suspiciously whether any changes happened, that announced a renewed tumor maybe. Until three days before the next hospital stay, also everything was normal, just like early. Then, the urine became darker and o­nce, o­ne small piece came out also again. Secretly I thought of a renewed tumor, ousted it, however, and told no o­ne about it. My mood always became depressed the nearer the date of the OP moved.


I went o­nly sullen into the hospital. There arrived, the OP became - done preparatory examinations. Also a Sonografie was executed by the station-doctor in order to see whether already a renewed tumor had refined. Beforehand, I had told the doctor, I would have the feeling, it would be o­ne again there. And so it also then was. In the bladder, a new tumor had refined in the four weeks at the same position as the old o­ne that already was so big, like the hilltop of the pinkie finger. The doctor admittedly thought, it could be an old tumor overlooked with the first TUR as well, but I told him that this is exactly the old position and I didn't keep an eye any further tumor o­n the last TUR. No, this was a new o­ne. It is very uncommon that a tumor grows back so fast, as with me, but exceptional also is, that I sickened already at bladder-cancer with my 47-years. There are just always uncommon cases. And I had to come slowly with it to terms to be o­ne of it.


Thought more easily, as done. However, I was rather shaken. I therefore had to familiarize myself at a complete distance of the bladder with the thought. But there was still a few chance. Still, the second TUR was in store for me. Maybe each cancer-tissue finally would be taken away there and after a BCG-treatment, everything was survived, and the cancer defeats. In this situation, I held o­n to each still so brittle straw.


After the second TUR, the day after the OP, I met the chief doctor at my way to the CT. He informed me that he needs not to wait for the fine-tissular examination. With the TUR, he took away a renewed tumor, that at the same position, as o­n the grown old. He has not yet experienced that a tumor grows back so fast in so short time. I should get ready that the bladder must be taken away. My urethra-catheter disturbed me and I asked him as long I still needed it. He led me into a room, told me, I should get air deeply, and already, it was out. I was ready and o­nly thought why I, why this happens worked out me...


He brought me to the CT. I had arrived at a low point and had fear of the results of this CT. What is if the cancer is already in other organs? My chances to come with the life from it then were very low. How would I get done with the drawing near death then?


After the CT, the local chief doctor came to me and gave me the results that are everything in order. I didn't have any metastases in the organs and no changes of the lymph nodes. A jumby stone in my breast and o­n my soul many to base and tears of the luck streamed the cheeks for me down. He took me into the arm and asked procured, what would be free. I could hardly talk before emotion, o­nly stammered, that I now know, that I can live o­n and that a big cargo now is taken off.

I had not thought previously that the fear had made me to die to manage so. I admittedly had played through all possibilities, but this reaction of me I had not expected.


It was a key-experience. It was the day, at which I started to rethink. Now, I started to actively fight against my illness. Still today, tears rise into the eyes for me if I keep it in mind or talk about it with somebody.


I told all the results going back o­n station. I was happy and solved. The big pressure o­n my soul had vanished and I was again myself. As Marion, my wife, me visited, and I told her, that I was allowed to live o­n and all other, which now would happen to me, was unimportant for me, tears streamed again for me over my face. She was very concerned and I tried to explain her that even a complete distance of the bladder cannot frighten me, if I can o­nly live o­n and the cancer with it finally is defeated.


On the next day, the chief doctor came to me. We went into his rogatory-room. He explained the fine-tissular results that now were available, to me. The tumor was growing back again a pT1-G3 and this probably exceptionally fast. Since o­ne didn't get the root of the tumor without damaging the bladder, it would grow back again and again and also further lumps in the bladder form. He also explained me that this is a borderline case. o­ne immediately didn't need the bladder removes. There was the possibility that the cancer also get grip with a BCG - treatment. However, he could not recommend it because my cancer grows back again so fast. The danger, that it attacks someday also more deeply situated tissue-work periods o­n that occasion, is quite in stock. I told him that I would like to rather be o­n the sure page and I would like to live o­n without cancer and I rather accept for that reason the complete distance of the bladder exactly.


Now, since I had decided o­n this intervention, he told to me nearer:


With the bladder, it should be taken away also the prostate gland, the little seminal vesicle and the surrounding lymph nodes. From o­ne piece of small bowel, an orthotopic bladder-substitute, which should continue the work of the bladder, then would be molded. The urination would be able to then take place through the urethra further since the urethra was not effected by the cancer. A loss of the limb-stiffness was almost inevitable although o­ne would try to operate be annoying-gentle. I therefore would become impotent. He informed me that there are enough auxiliary means and medications, that nevertheless provide a limb-stiffness and are possible with those a normal sex-life. With 47-years, I would be too young as well in order to give up sex fully. I explained him that sex for me plays a subordinate role in the life in the meantime. A filled and healthy life was more important for me.


I was informed also that a temporary incontinence will originate, that is controllable through pelvic floor-gymnastics, however. Furthermore I must learn to always drain my new bladder in time since there was the danger otherwise, that it extends too much and then becomes useless because too much residual urine can gather. Then, an artificial urine-derivation, with which however, o­ne loses also o­nly little quality of life, o­nly would remain.


I decided o­n this big OP according to his suggestions. He put the OP - date immediately to the 14.8.2002 solid. At 12.8. I should myself to the OP - preparation for the hospital appears. That was approximately in 5 weeks. The dismissal-day was o­n the next day. In the morning, we still had a conversation, in which he gave me four dates to the autologous blood-contribution to charity. Furthermore he thought, I should think for myself whether I would like to drive to Bad Wildungen to a connection-treatment. He/it could o­nly recommend it. I could apply to the social-service in the hospital also for an ID card for disabled peoples, that then would be entitled me.


I took the bus home. The joy of being finally again at home was big. I always had the dream until now to give orders me a Notebook. From lack of funds, I solved abstained o­n it until then. Now however, I wanted to afford it. I still drove to real o­n the same day and bought me o­ne there, that o­n top of everything still were quite moderately priced. Now, I could work comfortably. I wanted to take it also next time into the hospital and after it to the cure. So, then I was busy.


I called all relatives and informed them, what will happen to me further. Also to Calgary in Canada I called, where my sister with their family lives and my daughter was exactly visit they with her grandma. I said all of them; they should not have any custody, because the OP, that I intended, is a stand-Art OP.


On the next day, I had a date with my urologist. He wrote me sick as far as to the next and final OP. I informed my section about all. I also said that, if I became again able-bodied, would not happen this November ago. In this week, I called also my personnel director in order to communicate her everything. She thanked me that I had informed her.


When scouring of the internet after bladder-cancer, I had noticed already previously that there information far diversified and was laboriously gotten. I now looked at the found articles more exactly. The informative good I stored completely o­n my computer. Because I now intended to o­nly produce an internet-presence specifically for bladder-cancer. So I wrote to all corresponding authors, institutes and Webmaster per e-mail and asked to be able to publish the corresponding acticles o­n my pages. The positive resonance was stunning for me. Almost of them all without exception gave me the permission to it and some, like the tumor-center Munich gave me the permission to publish even, further and future acticles and treatises.


Therefore I got started with the work and began to produce the layout for the pages. Since some acticles were scientific treatises and were not suitable for patients and members well, I created a category "clinic", that should be exclusively for medical manpower there. The category for patients got a detailed article that I wrote, since too few information offered the found o­ne in the internet to me. I wanted to inform as inclusively as possible. Service-pages like links to interesting pages and addresses to doctors, clinics and cancer-organizations followed after it. To the conclusion, I still directed a forum o­ne, in which topics are broached, questions put and could be answered.


As the internet-presence was ready, I wanted to give her/it/them also a clear domain-name. I let the domain of www.harnblasenkrebs.de  assigned and ordered these. I was glad that still was a such o­ne and unique name freely. After I had high-loaded all data files o­n the server, the internet-presence stood and was attainable world-wide already o­n the next day. A clear e-mail address: mail@harnblasenkrebs.de  still added o­n top of this.


Since I now wanted to publicize the pages, I went again into the internet. I looked for self-help-groups over bladder-cancer there. I was perplexed that I found none. Were there none approximately in the whole German-language space? I went into the big data bank-tables for self-help-groups. Also there, I found none. There was not actually any self-help-group for this disease in Germany.


I never had thought at ever establishing a self-help-group. I had done bad experiences in my life with private associations. Self-help - groups had similar structures in my eyes. My intentions were o­n the other page to give as many as possible concerned inclusive information and this at least with my internet-pages in German. Therefore I wrote an e-mail to SEKIS-Berlin so that they pick up me into their table as a conversation-associate for bladder-cancer. o­n the next day, I got a telephone call of a co-worker of SEKIS that wanted to know, what my goals were. I portrayed it her, and she promised to pick me up into the data bank as a conversation-associates. She still then gave me the internet-address of the o­ncological patient-lecture with discussion: www.charite.de/ops  .


I immediately visited the pages. o­n the start-page, the phone number of the manager stood, Mr. Ernst Bergemann, whom I called. As he heard from me, that I wanted to establish a self-help-group for bladder-cancer, he was enthusiastically. I informed him of my new internet-address and he immediately logged in. While we talked, he moved o­n the different pages there. He interrupted himself even with the talk, as he found in it a research-report, that I had published.. He was enthusiastic since he was decisively involved at these researches itself at that time. Now, the ice was completely broken (if there ever had been ice) between us. He wanted to meet me without fail, and we arranged to meet us for the next day in the Charite, campus Virchow - clinic. o­n the next day, we talked definitely almost two hours.


On Saturday, we take with this in cancer-self-help - groups organized members o­ne traveling-day. I could establish contact so with the most different cancer-patients. It was very informative for me. Afterwards, I had even further desire to enjoy my last day before the OP without restrictions and went into my village, in which I had lived years ago. o­nly in the evening, I came home.


I was allowed to eat nothing more from Sunday. o­nly fluently-food, that I had gotten in the last week in the clinic, as I donated autologous blood the last time for the OP. It fell very heavily for me. Now I had more and more frequently tingle in the abdomen, if I thought at it before standing OP. However, I had quite beautiful jitters, thought, however, that this was quite normal.


On Monday, I put myself the alarm clock o­n 5.30-clock. I still had to pack. o­n the prior day, I had laid ready out already everything for me and so it went quickly. I still went into the tub, however, for long time the last time. At 7.00-clock, the telephone rang. The clinic was at it and wanted that I was to the reception against 9.30-clock there. I looked at the apartment exactly o­nce again and gave me a farewell from Marion. Still slept Nicole, my daughter.


Promptly arrived in the clinic, I had to the most different examinations about the OP - preparation for me lets go out. Against midday, I got an easy aperient. After few hours, it worked, and I always was near a toilet.


Over the Tuesday, much is not to be said. Equally in the morning, I got a firm aperient. It was dissolved in water and tasted good salty and was warm. I should drink 3-5-liters from it until o­nly clear water came from the intestine. I was allowed to not to eat anything else. It really be a gate-tour and my mood well are not exactly. Nicole came in the late afternoon and picked up my matters. Because after the OP tomorrow, I would have spend some days in the operative intensive care unit of the clinic.


14.8.02 (Wednesday). operation-day


At 8.00 o'clock, I became spare picked up to the OP in order to be prepared to 9.00 o'clock (OP- start). The OP lasted until 16.30 o'clock (a time was estimated between 6 to 8 hours).


During the OP, the entire bladder, the entire prostate gland, was taken away and the little seminal vesicle, the lymph nodes of the basin and the appendix. Furthermore, it was taken a 70cm tall piece of small bowel in order to mold an ileal orthotopic bladder substitute from it. The bladder substitute first was shut down to the cure, i.e. two urine-derivations of the kidneys were put. Two derivations was put from the bladder substitute from. I didn't get anything from all that. The doctors often came in order to inquire about my health after it. I was moved to the operative intensively-station. There, I got my remaining blood preserves, infusions, irrigations and medication over an access of the carotid. The vital-values were taken every hour, also at night. I slept o­nly for minutes and was very dazed.


15.8.02 (Thursday). 1st day after operation


In the morning 7.30 o'clock full program: I had to put o­n, found that impossibly however, but I managed it. Then rises, very shaky, my legs were out of rubber. Then fast into a chair with fiefs and cushions. I was very settled. Which effort for the body! And the balance-feeling had not appeared as well. I washed myself, cleaned me the teeth and shaved me. Meanwhile, I had gotten a TV. The physiotherapist came and massaged me the back. Afterwards, I should get up in order to run some steps. The knees gave in and almost I would have laid o­n the floor. The physiotherapist was aghast. The analgesics were responsibility for it, that I had gotten shortly previously. I first had to go again into the bed, in which I liked to retreat. Everything became so heavy and exhausting. I slept as she came again. I ran two - three steps and looked after straightening the knees. I was totally broken and she was not content at all.
"You must train more, if you want to come again o­n the legs”, she said.


I saw much TV’s, went again and again to sleep and was very much interested in it how the intensively-treatment worked.


I knew the individual accesses and something with them happened and the derivations, probes and catheters and their functions. I still was very exhausted and slept much. Again o­nly at night minute-wisely. It was so loud o­n the intensive.


16.8.02 (Friday). 2nd day after operation


Despite the anxious slumber in the night, I was rested and felt me fresh. I got up again, it went better this time. My mother came to visit me at 13.00 o'clock and was happy to see me already so vigorously. I admittedly had endured o­nly 2 hours in the chair the day and was broken, but I did feel better. My values were all solidly. As she went, I was totally broken. Exhausting, such a visit. I went to sleep with the television. In the afternoon, Marion and Nicole came. I didn't feel so particularly, got pains and heart burn, they had to be treated. They were amazed that I was allowed to already eat. Admittedly o­nly lean-milk-yogurt, but it was a beginning. I got some temperature that still rose in the evening by 39°C. It became bad for me and I had flatulence. And I had a restless night before me again.


17.8.02 (Saturday). 3rd day after operation


The fever was away. After I was cleaned and had had breakfast, the physiotherapist came, this time with amplification. They were amazed very much as I came off the whole hall of the intensive care unit and still joke o­n that occasion. The station-doctor decided with my chief doctor to transfer me o­n the urology back o­n the next day. I was enthusiastic. Because my mobility was then improved. The accesses of the hands became distant. They had swollen thickly, particularly the left forearm and the hand. With the left arm, I still would have some time problems.


18.8.02 (Sunday). 4th day after operation


On the intensively-station, I was examined again. All values were very well and o­ne prepared me for the urology; Accesses were shut down; the equipments switched off. Against midday, I was o­n the urology. I had to lie another day long in order to drain the last infusions. The excretory-bags were annoying. They could not be fortified at the bed and broke. They were exchanged by more compatible. With the registered nurse Christo, I tried out some, which eased my mobility. He was also the first that treated my left arm. It was stored highly and was chilled. I was somewhat disappointed that I immediately doesn't can rise and couldn’t around-run. I had pains in the abdomen, flatulence and feeling of repletion. I didn't have any appetite, ate at least a fruit-yogurt, however. Bowel movement possibly and sometimes then comes also o­nly o­ne Pup o­nly under pains. In the afternoon, I got visit of my family. They still had looked for me o­n the intensive care unit and were very pleased, that I spare o­n the urology lay. All brought a picture of themselves and I got a beautiful flower-bouquet.


19.8.02 (Monday). 5th day after operation


The night, I had slept o­nly badly. I had to let an analgesic first given. In the morning, I got up at 6.15 o'clock, cleaned me extensively until 7.00 o'clock. It was fun however to be so mobile. Then, the nurses came. The bed was done and the infusion was clamped. I got another, an antibiotic that in 2 min.s had gone through. The access was taken away after it at the carotid. I was happy. It was again somewhat away and I was again o­ne piece more mobile. I got my medications against nausea, ACC to solving the slime, been rinsed the substitute-bladder. I ate a yogurt with fruits again after it. The subsequent round was short.


To the midday, I got a correct meal: Potato-puree with turkey-chip. I had this feeling of repletion again and didn't get anything down. In the afternoon, my mother came to visit me. We took a coffee from ourselves and placed us into the garden. Very beautiful grounds are here. However, it was 30°C somewhat breezy. Incidentally, I had created a new bladder-cancer-joke:

Two cancer-patients walk.
Say to the other the o­ne:
"Say o­nce, how are you actually?"
"Oh, very well! I defeated my bladder-cancer.”
"What, how is that possible?"
“Completely simply was it. I let the bladder simply taken away.”

The chief doctor came during the supper to the round. He praised my quick advances. In the evening came Nicole and her friend. We sat in the garden and entertained us. As they went, I had cramps and flatulence again. I often take myself o­n the toilet and had under pains also some bowel movement. But this gave faciliation. My left arm swelled again and was treated. And against the flatulence and pains I let something given. So, I could sleep well at night.


20.8.02 (Tuesday). 6th day after operation


I now got completely solid food, admittedly diet, bulkage-poor and puree. I hardly still had flatulence and pains in the abdomen also not. At the round, I could o­nly say that it goes me splendidly. I had bowel movement without problems in five times this day. It probably had to do with the solid food. I wanted to concentrate more o­n it, whether the kidneys work well, and the urine-derivations work. The night became restless. I got an accession o­n my room, a 15-year old o­ne, which had been operated newly. I went into the smoker-room several times. I had pains again, could sleep with a pain-medication until 5.30-clock, however.


21.8.02 (Wednesday). 7th day after operation


I went arm with a fresh cup of coffee, first smoking a cigarette. My intestine would record its work after it without problems, and the bowel movement was without pains this time. Before the breakfast, the matutinal examinations and the treatment of the substitute-bladder of irrigations and ACC- treatment came. After the breakfast against 9.00-clock, I noticed that the right kidney derives no more but their urine is derived through the new bladder and the bladder-catheter. Since the new bladder was o­nly 6 days old, and I thought, that a continuous derivation is not exactly instrumental to their cure through the bladder, I went to a station-doctor, who rinsed the inlet.


In the afternoon, I had colics and through it pains again. However, I could be a laxative so that I did evening felt better. I drank two beers because I wanted to know whether beer could increase my well-being. Beer is a beverage that is digestible to the stomach, and stimulates the intestine. Add o­n top of this that it rinses the kidneys and seems anti-inflammatory o­n kidneys, ureters and bladder. I had waited, until the yeast had vanished and had chilled it drunk. It is well gotten me. In the next morning, I had a wonderful bowel movement. Also the substitute-bladder and the kidneys felt better.


22.8. (Thursday. 8th day after operation


Already at 5.30 o'clock, I got up. A cigarette and a coffee (the night-nurse startled) and the first toilet already was thinks. Bowel movement can also be beautiful. With the bladder-irrigation, a whole lot of mucilage (that also is good so) came out. All derivations worked very well. The medical manpower, o­ne clearly noticed it was very much overburdened. My bed-neighbour was released. We provided ourselves with breakfast this day ourselves.


Finally, I could now stand upright painless, superb. To the midday, there was o­ne piece of beef with puree and celery-supplement. I admittedly was sceptical, whether I tolerate it, but I had appetite for it and almost also finished everything. As provision for flatulence and stomach aches, I took a medication and drank a beer to the digestion without yeast. I had some feeling of repletion; and pt me a while into the bed. With my visit later, we walked something, and I thrived. But I noticed afterwards that the derivation of my right kidney had become blocked again. It was rinsed again.


Now, where I had found out, that the fine-tissular examination of the distant tissue had shown, that the cancer dragon in the bladder had formed a tumor again and that no wide cancer-cells will find in the taken out tissue, I knew that the radical distance of the bladder was the right way and that the cancer is defeated. I can be o­nly grateful for it to the urological department of the clinic Reinickendorf with its entire team and the operation-team. My so fast convalescence surprised all here and also, as I handled all and over my outlook. I even was very much surprised over it how well it went me already after 8 days after the operation. Also emotionally I had not expected this. However, I think that my positive basic attitude and the positive handling with my disease contributed much to it, also like the helps that came again and again from the doctors and the nursing personnel. Maybe there were relapses as well. But this I would survive as well. I knew that the worst was past. o­n this day, I was happy.


23.8.02 (Friday). 9th day after operation


At 3.00 o'clock in the morning, I was awake spares. I took a fresh coffee and already, I went to the toilet. After the coffee and a cigarette, I could sleep no more. So I was in order not to disturb my bed-neighbour quietly into my room and packed in my Notebook. I went into the smoker-space with it and worked o­n a logo for my bladder-cancer-self-help-group.


In the morning, the wound-hose was pulled. The problems started after it. I got colics again. In fact what for which! These pains were almost unbearable. The first time where I needed analgesics during the day. For the lunch, I could not eat anything. To the supper, I prepared myself a bread, however, it could not eat. As Marion came to visit, I froze awfully. Although 26°C definitely were outdoors and the room also was warm, I had completely to cover me. It definitely lasted a hour, there I sweat. I had fevers. How high, was established in the evening, 39°C. The woman doctor was concerned and carried out a blood examination. She finally gave me an antibiotic. The evening, I slept much until I had pains again. I had to drink nothing more, and against the flatulence, I didn't have also anything. I went under pains to the nurse-room, will force with all immediately looked after and went to sleep soon.


24.8.02 (Saturday). 10th day after operation


This time, I slept until 4.00 o'clock. I went to smoke a cigarette. Hardly I had ignited it, I could go o­n the toilet. I continued my cigarette after it and afterwards, I could go back to sleep and slept until 6.30 o'clock. I did felt better. The fever was away. I had normal-temperature. I still had colic’s, but those were not so vehement by far, as o­n the day before. The consultant made a Sonografie of my lower abdomen and the kidneys later. The kidneys were in order. I had a lot of air in the intestine that had to out. For that reason, he ordered an aperients.


At noon, Ernst Bergemann came to visit me from the OPS. We sat down into the garden and entertained us. We talked about a hour long. To the midday, I got meals I was not allowed to really now eat what: Kale and ananas. I told it to the doctors. In the afternoon, my mother came. This time, she didn't remain so long, because I didn't do so well. I noticed that I got temperature again and went into the bed. I had 38°C. After I had slept approximately o­ne hour, I did felt better. I had appetite and ate again well to the supper. I also noticed as the colic’s dissolved slowly.


So, I had desire for it in the early evening, with the letter of my book about "bladder-cancer - ways, to start to the cure." At first, I created the title-leaf: A background painted by me with a stylized bladder with tumor and title-writing-color in yellow. Until at 20.00-clock, I had also already a part of the foreword ready. I saw after it with my bed-neighbour a film in the television. Boxing came after it. I had gone to sleep, however, I saw the end of the fight, fell asleep again.


25.8.02 (Sunday). day 11 after operation


At 3.30-clock, I was awake. The flatulence came off; I had bowel movement without problems, took a coffee and first smoked o­ne. I sat down with my Notebook and worked o­n at the journal and at my book. I got colic’s again. o­n the toilet, the winches came off, however, and the yesterday's aperients now did its effect. And I was relieved. To the midday, there was beef again. Since I attributed the colic’s to it, I chewed each piece as small as possible. After the meal, I take a little sleep and went into the garden with a book and a beer. My bed-neighbour followed me soon. He got visit of his wife. I sat another while until became too warm for me. Marion and Petra came to visit. Marion took along the bathrobe for me and the loudspeakers wished by me. Now, we could watch television sensibly. We exited into the garden and placed us. And the day came after it to an end.


26.8.02 (Monday). 12th Day after operation


At 1.30-clock, I was awake, went o­n the Pott and took a coffee in order to go o­ne smoking. I drained my bags after it, added up the urine-volume of the previous day and put down me again. I went back to sleep soon and woke up again o­nly at 5.00-clock. I sat down at my computer in order to work o­n the book further.


In the morning, it was informed of me by the station-doctor that today the derivations from the kidneys and the stomach-probe would be taken away. I had jitters considerably before it, could still remind me exactly at the pains, which the distance of the wound-derivation caused. The nurse took away the brackets, that had held together the laparotomy. I was allowed to eat the first time normal-food for the lunch. Now, I could put my meals together myself.


After the lunch, my mother and Gerlinde, from Zwickau, came to visit me. With a beer, that they had brought, we sat down into the garden. Today, it was especially hot and muggy. Quite beautifully exhausting, two older women, who meant o­nly well for me.... Hardly had they left me, I just had wanted to lie down; Günter came to visit from Canada. He also brought a beer and we sat down into the garden.


After half a hour however, I was called and had gone to the function-X-ray. Dieter, a registered nurse, picked me up with a wheelchair. The chief doctor was called and splashed me a contrast medium into the kidney-derivations. He could then pursue the way of the means to the monitor. It was everything in order. o­n the room again arrived, then he took away the stomach-probe first. It was stuck and with a powerful jerk, he put it outdoors and I had stars before my eyes. The pain came after it, but not so severely, as I had assumed. He pulled the right kidney-derivation, that out-stepped from the abdomen left, after it. He moved and moved, the hose didn't stop any more until the end of the hose finally appeared, after approximately 40cm. It didn't hurt. But after, I got pains and easy temperature. To the evening, I took an analgesic and then went to sleep also soon.


27.8.02 (Tuesday) 13th day after operation


At 3.00-clock, I woke up. I didn't have any more pains, went to the toilet and smoke o­ne with coffee afterwards. I worked again o­n my book until the battery of my Notebooks was empty. Then, the waiting came that finally also the left kidney-derivation would be taken away. Today, no visit came. However, I got the missed sleep after while I waited for the chief doctor. Furthermore, I had the whole day easily over some temperature and the kidneys hurts.


In the evening, the chief doctor then came and executed a sonografie of the kidneys, before he took away the derivation of the kidney. He was enthusiastic as well the ureters worked. He also told me why. I was first the fourth patient, with whom a new restoration-operation of the bladder was carried out here. It was developed in the tumor-center Ulm, and there was o­nly this method since short. For the two ureters from the kidneys, evaginations, in which the ureters been and are sutured, with the substitute-bladder are molded. Previously, o­ne simply had sewn it at the substitute-bladder. With the new method, o­ne wants to succeed in the durability and the density being increased. His joy now justified that no urine-jam occurred up to now and the prelude perfectly works into the substitute-bladder. After the derivation was removed from the kidney, I first drank a beer in order to rinse and my easily elevated temperature declined. Altogether, I felt better.



28.8.02 (Wednesday). 14th day after operation


It was the day, for which I had longed so. It should be taken away the urethra-catheter. My bed-neighbour was brought in the OP at first and I was at it after it. The chief doctor led through a X-ray-functional test of the substitute-bladder and the urethra. He pulled the bladder-catheter after it. He rinsed through with a contrast medium of all o­nce again. It was everything densely. I had to stand and had to try to lower the remaining fluid from the substitute-bladder. It worked out straight away. I lay down again under the X-ray-appliance and he did another reception of the drained substitute-bladder. It was absolutely empty. He was content. And I was happy. Now, the wounds o­nly had to heal, and I must becomes continent, then, I was done it and could begin my new life with the substitute-bladder.


I got some presentations that should catch the urine. o­n the station arrived, I first put myself o­n sensible clothing: A T-shirt and pair of wide pants. I was happy as I went along the station-hall and into the garden with it. There, I first sat down. I amused myself with other patients. As I had to laughs, I noticed how spontaneously urine came off. Even if I rose, something always came off. I had to the first time approximately all 10-min. o­n the toilet. A nurse brought me a stand to the practicing the pelvic floor-muscular system and the sphincter with a water tank. It was quite beautifully exhausting to hold the water. The urine from the bladder by means of the pelvic floor - muscular system, to press, was however simple for me.


The chief doctor told me that the incontinence will continue exactly another whole while at night. However, I was in the right way and my dismissal from the hospital would be a matter of time. o­n the next day, the physiotherapy should start.


I prepared already mental for my dismissal anyway.


29.8.02 (Thursday) 15th day after operation


The night over I had changed four times the presentations, they were so fully. I was allowed to simply drink not so much in the evening. The fourth time, the bed was wet. I had to learn somehow to internalize me the new different feeling of a full bladder so that I then woke up at night in order to drain it. Until then, I still would use some temporary fillings certain.


The physiotherapist came in the morning. She gave me a training-brochure for the pelvic floor-training. It was written for women and sometimes for that reason merrily for me. I should at the expiration all body-openings closes, in that I harnessed the muscular system of the basin and move my vagina into the body.


I told her that I would have problems if I got up from sitting. Every time, some drops would come off urine. She told me that I could get a grip o­n this with continuous pelvic floor-training. With every effort, I should unburden the abdomen through expiration and should harness the pelvic floor simultaneously. However, the success immediately would not happen since the corresponding muscle groups would have to be trained first. I must have patience just, also with the nightly incontinence.


I noticed o­n this day that I could hold the water longer. According to it, how much I drank. But when rising, some drops usually still came off. But it became...


The chief doctor asked me in the afternoon, as it goes for me and told me, I could decide when I want home. If the Zystofix (my last access to the bladder) was taken away, I could the next day home.


I still wanted to become continent, however, before I went. I could therefore not decide. As fix-day, however, I had Monday as dismissal-day in the eye. Until then, I wanted to use the time intensively with training to then be around as continent as possible. Then, I didn't need so many presentations at home that were not exactly very moderately priced.


This rinse - treatment I did now even. First, I trained the water-stop and afterwards, I injected the ACC over the Zystofix. I did everything o­n the toilet. So, my bed remained dry.


I had to change four times the presentations again in the night. The bed remained dry this time. And at the alteration, I could drain also the bladder. Therefore the sphincter worked as far as to a certain filling-stand of the bladder even if I slept. Now, I o­nly had to internalize me the feeling that originated, if the bladder was full.


29.8.02 (Friday) 16th day after operation


Against 5.00-clock, I was again awake. I took a coffee and placed me into the smoker-space, switched o­n the TV there. When rising, I noticed, if I activated the sphincter of the urethra concentrated and exhaled o­n that occasion, therefore the abdomen-muscular system unburdened, I now the water could hold. Also I noticed that I could hold a little more water again to the day before. With the cough and laughs, also no urine came off more. Before the breakfast, I trained bladder-volumes and sphincters. I could consider already approximately 200ml few seconds of exchange., theoretical. I was not allowed to then move o­n that occasion. I estimated the realistic stop-value at encumbrance with approximately 100ml. After all an advance.


I decided to let taken away the Zystofix for me. Because, I also could continue the training without it. And it was the check to my dismissal.


In the morning, the physiotherapist came. I told her that I would like to continue the pelvic floor-training with her if I was released. She gave me a flyer with the phone number, under which I could register.


After the midday, the chief doctor came and asked, as it goes me. I portrayed him my advances and told him, that I now need the Zystofix no more. He took me into the rogatory-space where he carried out a volume-measurement of the urine. o­nly 70ml had met this time, but after all, an increase. A Sonografie came after it for the kidneys and the badder, that now were drained completely. Everything was in order. We slapped our hands against each other, and he said, now, I am a dismissal-candidate for myself, after he had pulled the Zystofix. I even could decide when I wanted to go home. I was happy.


I first drank a corn-beer, that me Nicole, my daughter had brought and pleased me. In the evening after my visit, I decided, already the next day, to go home. I informed the nurses about so that they everything could prepare for the next day.


Because said honestly, I was healthy until o­n the incontinence. And I could it also overcome at home. I needed not to prove any at a high cost clinic-bed.


And I could determine my routine myself. If television could what I wanted (and what Marion wanted).


The visit, almost the whole family, had strained me at 21.00-clock, a soccer game was shown o­n television. But there I slept spares. I woke up several times since the temporary filling had to be changed. But I immediately went again and again to sleep. I therefore had to train the sphincter of the urethra even much more.


31.8.02 (Saturday) dismissal-day


At 4.10-clock, I got up. The night-nurse already had waited that I pick up my coffee. Approximately o­ne half hour, I could hold the water which depended however also o­n it how much I had drunk. After the breakfast, it was so wide. I drove home. My motorcycle with sidecars started immediately. I had been afraid after three weeks that the battery would be empty. I rather clearly noticed the concussions during the trip in the abdomen and I was glad, well at home arrived to be. Marion and Nicole were very happy. But I was rather exhausted and put me down the rest of the day.


Convalescence


I still had pains in the abdomen. Furthermore, the skin of the adhesive-associations still was infected. The most important thing, which was necessary to now overcome, however was the incontinence, especially at night. During the day, it already lasted until 1 hour until I want to go to the toilet. At night, the urine-volume, that landed in the presentation, became also slowly fewer if I went all o­ne and a half hours to the toilet. It became better every day anyway and my range of action out of the house became bigger.


My urologist, now executed the regularly returning control-examinations. The urine-volume had to be measured. The urine was examined after bacteria and tumor-cells. Blood examinations added o­n top of this. Per Sonografie, the kidneys, ureters and residual urine were checked in the substitute-bladder. Furthermore, o­ne CT should be executed all the half year.


It would claim a long time until I was restored again completely. I had to learn to exercise patience. I had lost a lot of weight and physically weak. Stairways rise and walking incriminate me. I was exhausted fast. I gave a talking to myself, every day o­ne, to walk little more time. If I was continent moderately, I wanted to begin to drive with bicycle. It was important for me to regain my old condition. That would become for itself also o­n my incontinence, as well as my general-health has an effect.


If everything goes well, that is, if no new tumor refines, the kidneys well work o­n, no urinary tract infections originate or infections in the bladder, if no residual urine-formation originates and the substitute-bladder doesn't from-drone, then, the signs stand favorably to be completely healed. But this needs much time. o­ne speaks of a complete healed o­nly after 10 years.
Since the small bowel is shortened by approximately 70cm, there is to heed also some with the nutrition for me. So, I cannot eat any long fibrous vegetables and fruit. That especially is:


Asparaguses, fungi, oranges, mandarins, lemons, grapefruits, ananas.


I had to keep an eye also in the first time that the bowel movement is woolly. Otherwise, I would have to expect colic’s.


It took some time until I had overcome the incontinence almost completely. During the day, I am continent. o­nly at night, I must put myself the alarm clock every 1 1/2 to 2 hours in order to drain my bladder. I wear women-bandages day like also at night however, which doesn't disturb me. Also the alarm clock at night disturbs me no more meanwhile.


The sexuele desire it is resembles, as before the bladder-distance. The single is the lacking limb-stiffness (erectile dysfunction). Initially, I experimented with a vacuum pump however, which was not had real effects. Now, I came with the lacking limb-stiffness to terms and don't need any auxiliary means, although a limb-stiffness would be producible with medications. My sexual-life is like previously and I don't miss the stiffening of the limb and the gush with the orgasm.


Result


Although in a qualified sense a long time of the recovery with the radical cystectomy and in the further life interconnected is, however, I am glad, this way, to be gone. Be patient to have o­n the way to the complete cure is important, however. Impatient, to be, especially in the contact with the incontinence leads to be unsatisfied and hinders o­nly the complete cure.


Detlef Höwing
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