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Friday, March 30, 2012

So, how is your PSA level?

Reader Warning: If you are the least bit squeamish, do not continue! This will be true especially if you are a male member of the species. Females having experienced childbirth simply refer to this as payback.

Yesterday I had my first annual appointment with my new urologist, Doctor Joy (first names only) up at ADC-North—actually my first female urologist as a matter of fact. She replaces Doc Koushik who I saw only once prior to him moving on to greener pastures. Doc Koushik had been my new urologist then only because I had fired my old urologist. I won’t go into that here; if you want to know more on that front you will have to search the archive on my blog site.

I had a consult with Doc Joy the prior week after I finally got around to calling; Patsy had been on me for some time to do so. She was surprised that I got an appointment to see any urologists that quick; but I did. We discussed where I was and what had brought me here; talked about Doc Libensky (last name in this case only), the guy that started all this back in 2002 and his replacement; I saw him (can’t recall his name; oh yah, it was Doc Pradeep) once before he also left for a greener pasture. Doc Joy checked the computer and found all my records to still be intact; even the visits with Doc Steven—the Doc I fired—had been sent over routinely and scanned into the database).

Nothing left to do now but the rectal exam that my primary passes off every year to my urologist visit—it’s easier on both him and me for the urologist to do so but eventually it has to be fingered. Yes it did and so I drop trou and bend over the table. Probing complete, Doc Joy recommended that I set up appointment for cysto and CT scan with Nurse Laura and quickly departs; the visit bringing to mind a short porno loop fro the 70s.

Yesterday, after fighting the MOPAC traffic for over an hour, I still arrived early, maybe ten minutes or so; took my place in the waiting area; opened my current book and started to read. Almost a full chapter later, I was called back and quickly ushered into a restroom for the opportunity to provide a urine sample. “OK, I can do that.” This is not always an easy task with your mind in a far, far away universe thinkin’ of what is yet to come. This time I had planned ahead in order to comply and eventually accomplished the task.

Returning from urine compliance, Nurse Laura showed me to the exam room. Nurse Laura says: “You know the drill?” as she directed me to disrobe completely below my waist, offering me a sheet to cover myself—sheet is the hospital slang for large piece of paper not able to withstand the slightest rip or tear.

“Yep! That’s easy for you to say! This will be the eighteenth time, but that doesn’t make it any easier.”

Both giggle and move on. She says to “lay back to get comfortable.” I move to a reclined position and take advantage of the last peaceful rest I will have for the next twenty-four hours.

Nurse Laura starts ripping at the sheet covering me, places a sterile covering over my nether region, grabs ahold of what she can and starts swabbing.

My mind begins to remind me in stark realism of what is to come and I roll into the world of memory, hoping to forego the entire procedure. My body knows otherwise—the anxiety of what is ahead causes me to break out into a cold sweat and a tenseness of muscles that can only be matched by rigor mortis.

With closed eyes, like that could help, I am transported into an outta-body state and begin to recall the cystos of the past.

I am alone in the exam room with absolutely nothing to occupy my mind but thoughts of the torture to come.

Soon, the nurse is back through the door pushing the dreaded cart with the ultimate device of torture. You can’t see what’s on the cart—it’s covered up to keep it sterile; but I know what’s there—you bet I know.

Nurse says: “Are you allergic to iodine?”

“No.” They ask this every time, sometimes more than once. Those allergic to iodine must have some awful reaction to it as they make a big deal of it.

“I gonna wash you. You might feel a cold sensation.” Then she starts. (The he and she are interchangeable from this point on.)

Cold! Are you kidding me? Iodine is cold. You know how cold alcohol feels when you apply it to your skin. The reason for this sensation is the rate of evaporation as it dissipates into the air. Well, iodine evaporates faster than alcohol and the medical profession is not bashful about the application of iodine. The nurses sorta just poor it all over the intended area and dab away to insure cleanliness. But COLD it is! I always thought this was just to get you ready for the next step.

Nurse says: “OK, now I am going to apply lidocaine down the urethra to make it feel better during the procedure.” She grabs Mr. P, squeezes to open him up and begins to push the lidocaine outta the tube. It feels like she is pushing the tube down Mr. P’s throat and by-the-way, it burns like HELL.

Up to this point we have been both frozen and burned. You might ask what can come next. Well, I’m gonna tell you; patience my reader, patience, I won’t let you down.

Nurse says: “I’m sorry about that.” You might believe her; I don’t.

After all I have previously suffered; the goal turns to keeping the lidocaine inside—don’t you dare let it ooze out. This Nurse does with one of those big black clips that you most likely have used to keep a three inch stack of your tax forms together or notes for your next staff meeting. That’s right, one of those big black clips. Don’t ya dare think they have removed any amount of tension fro that clip? Nope, not a bit; it’s just as strong as it ever was. B-e-l-i-e-e-e-v-e me! Now, there you lay, covered by a big paper sheet, Mr. P adorned with a big black clip sticking up through a whole in the middle of the sterile pad—not at attention or even saluting; Mr. P’s head is hung low.

Over her shoulder Nurse says as she departs: “We’ll be back in a few minutes to do the procedure. Just rest now.”

Rest! Does the medical profession even have a clue to what constitutes rest? I don’t think so.

Again, I am left to cogitate my predicament and what is yet to come. The time seems to stop, anxiety builds, no movement whatsoever. H.G. Wells, where are you?

Weird thoughts run through your mind during this lull in the action; not the least of which is: RUN and RUN fast.

Before you know it, the door bangs open and in strides the Doc and his team in force. My first thought: “Why does it take so many?” Ya know there always seems to be somebody in need of training and I seem to always be chosen for the guinea pig for such activity; my fate I guess. At this juncture there is a great deal of scurrying around and equipment checking that takes place. Another thought pops into mind: “Why haven’t they already checked the equipment?” Directly, they are ready to proceed.

Doc says: “I’m going to insert this device, then I will fill your bladder with the solution from this bag and we’ll look around.”

I always wonder who else he’s gonna allow to gander so I ask. “Whadda you mean we’ll look around Doc?”

“You can see every thing I see on that monitor right there” as Doc points at a TV monitor sitting over my right shoulder. I’m laying back with that big black clip strangling Mr. P and he wants me to crank the top part of my body around so I can see what he sees—no way is this about to happen. You would have to be a contortionist to accomplish this. I am not sure I wanta know what’s going on in there anyway.

Doc removes the clip and I experience a short moment of relief—still burning, but better.

“Now we begin.” Doc starts insertin’ the torture device into me and says: “Take short quick breaths and it will be better”

“Ahh. Ahh. Yes, OK. Ahh ahaah.”

Did I mention that the device was the exact same size as an NFL football—maybe I forgot to tell ya that? Well, as far as I am concerned, it’s the exact same size.

“Ahh. Ahh. Ahh.” That lidocaine doesn’t seem to be doing its part or even coming close.

“There’s the prostrate. It looks enlarged.” OK, it’s enlarged, but this does this stop the onslaught? No way, it continues.

“OK, here’s the bladder. Now we’ll fill it up with sterile water.” There he goes again with the we’ll. As far as I can tell, he is the only one with any control of the football device.

“Ahh. Ahh. Ahh.”

He starts the water flow.

“Ahh. Ahh. Ahh.”

“How are you doing? Are you watching the monitor?”

“Ahh. Ahh. OK so far Doc. Ahh. Ahh.” As far as I can tell, Doc has rammed the football within about an inch and a half of my tonsils or so it seemed. I know for a fact that the lidocaine isn’t doing its part.

The Doc and his crew are talking to you just like it’s an everyday conversation and all you are trying to do is stay alive and breathe; just breathe.

“That’s all the water and the bladder isn’t yet fully extended; too many folds. We need more water.”

Doc says: “You have a large bladder. Possibly the second largest on earth. There’s gotta be a blue whale out there with one larger than this!” Off goes the nurse to get another bag of water. Time keeps ticking by. So much for the thoroughness of the equipment check.

“Ahh. Ahh. Ahh.” I continue to breathe as the dock pats me on the knee and just smiles.

Nurse is back. The new bag is hung and flowing.

Doc says: “Now that’s better.” He begins to look around.

“There’s the operation spot. It still looks goods—no grow back.”

Don’t get me started on the operation. That is another story all to itself.

“Uh oh, what is this? There’s a small protrusion on the upper left quadrant. See it?”

Hell no, I don’t see it. Man, I’m doing nothin’ but breathin’. “Ahh. Ahh. Ahh. Ahh. Ahh.”

Doc turns and asks the nurse for the Bowie Knife device (not the actual name of the device, but you get the idea)—I never caught the name and never hope to . As you might expect, it was not in the exam room either. The nurse high tails it outta there for the Bowie Knife.

Bowie Knife, you might ask. This device slides down inside the football size tube and as far as I can tell, you have to insert it crossways or it won’t work. So crossways he did—as far as I can tell.

“You might feel a little pinch. Are you ready?”

“Ahh. Ahh. Ahh. Ahh. Ahh. OK Doc. Ahh. Ahh. Ahh.”

A little pinch, HELL! There was a whole Latin Quarter knife fight goin’ on down there. I think some of the guys had brought machetes, maybe even fencing foils; I couldn’t be sure.

“There, we got it.”

Again with the we. Why do they do that? Are they trying to make us feel as we are part of the team? I don’t wanta be part of the team; I just want this to be over.

“Ahh. Ahh. Ahh. Ahh. Ahh.”

Now Doc is dragging the Bowie Knife back out. I am positive he used the same procedure to get it back out as he used getting it in: crossways.

Everybody seemed to be proud of the team when they finally got that Bowie Knife back out. They were digging around for a specimen jar to capture the culprit in and send off to some CSI lab for analysis.

Doc says: “Ya wanta see what we took out? Here, look.” he says as he shoves it into my face.

“Ahh. Ahh. Ahh. Ahh. Ahh. OK Doc. Ahh. Ahh. Ahh.”

Doc goes back to looking around again. “The rest looks pretty good. Get ready for me to come out now.”

Removing the football sized device is about as eventful as removing the Bowie Knife; except it wasn’t brought out crossways—it just felt like it was.

“Ahh. Ahh. Ahh. Ahh. Ahh. OK Doc. Ahh. Ahh. Ahh.”

Then it’s over. Talk about an Alka-Seltzer moment, this was it. You have no idea what a relief it is for the procedure to be over.

Doc says: “OK. We’ll leave while you get cleaned up and then we’ll talk.” They depart leaving just me and the new trainee guy.

Training Guy says; “Man, I thought ya were gonna raise up off that table and hit him. They shouldn’t have males in here when they’re doing this—it’s too much.” Without stopping to breathe, he continued: “This is my first day and my last; I can’t do this! As soon as I help you get cleaned up, I’m outta here.” And he was. I found out on my next visit that he had given notice that afternoon and came back only to get his first and final paycheck. As fretful as this was for Training Guy, I had no symphony for him.

Eventually I return to my body and begin to redress myself. Doc Joy soon rejoins me and we discuss what had taken place.

I have now been clear of cancer for ten years and will no longer have to experience this torture every three months or every six months or every year for that matter—never again.

“Ahh. Ahh. Ahh. Ahh. Ahh.” Now I just gotta get over yesterday


  1. I knew from the moment I saw the title exactly what this would be about ... but I didn't, as I haven't been diagnosed and I'm only in the high PSA stage. I thought the biopsy was bad, but I was wrong!

  2. Mark, Sorry I haven't responded. I've been out celebrating for the last several days and just now getting over it.

    No the biopsy is not the worst, unless that's where it stops. Including the initial scope, the biopsy, the surgery, the quarterly followups, the semi-anual followups and the annual followups; I suffered through eighteen of these procedures - more than any one human should have to endure. But that's all behind me now!

  3. I had this done many years ago (due to chronic bladder infections.)I am female, but I still remember it as one of the most painful experiences--and not just during the procedure, but after, since I had bladder spasms for 24 hours. I don't know why they don't do this under gereral anesthesia. Today they do colonoscopies under a general, even root canals at some places. Of course, you may have to pay more but from what you have written, it sounds worth it. BTW, I'm glad you won't have to go through it again.

  4. Thanks for your comments Nancy. I didn't find the procedures painful so much (a couple of times there was some irritation for a day or two afterwords) as they were just so anxiety filled. I actually went into shock after one that went unusually long due to lack of prep on the medical team (extra water & the Bowie Knife - both had to be retrieved).