Visit To My Urologist

Wall chart in my urologist's office this morning which I was viewing while waiting for him to see me

This morning I had my semi annual visit to my urologist. 

For those of you who have been following my blog, you know that I have had my issues with kidney stones in the past. Have I ever. 

During my last visit to my urologist, he was monitoring a small kidney stone that was at the top of my urethra, ready to drop. After viewing my latest CAT scan, that kidney stone is no longer visible. He asked me if I passed the kidney stone.  I told him I may have but I didn't know it.  Sometimes the kidney stones are so small we don't realize when we pass them.  All the kidney stones I remember "passing" were the one who got stuck in my urethra. Oh do I ever remember them. I've lost track of the number of times I've had those kidney stone attacks. I think I've had six of them, all requiring emergency room visits, two over night stays and three operations to remove them. So this was a bit of good news today.

I also took a urinalysis today.  My doctor told me he found a "trace" of blood in urine.  It said it could be nothing but just to be on the safe side he's sending it in for further testing.  He said it may be necessary to have that procedure to check my bladder for bladder cancer. This is where the doctor (or one of his helpers) sticks an instrument with a small camera on the end up my penis to check my bladder.  I've avoided this invasive procedure twice in the past ten years but it looks like my time of reckoning has come.  I hate these invasive procedure, especially in THAT area.  I've already had a stent inserted in my penis for three weeks and folks I'm here to tell you, that is no picnic.  Very uncomfortable wearing it (you feel like you have to pee all the time) but the worst part was taking it out.  So I await my doctor's verdict if I have to undergo this procedure.  

At time like this I remember back to those halcyon days which I went years without visiting a doctor. Years in which I didn't have this constant mucous buildup in my throat which makes me feel like I'm suffocating.  Years in which I was limber enough that I didn't ache in pain with arthritis when I wake up. Years in which I didn't require an afternoon nap of at least an hour's duration.  But you know folks, I'm thankful for the good health I do have.  Could be worse, a LOT worse. 

Tomorrow I have off then on Thursday I work at the hotel Thanksgiving Day. I work the following two days for a co-worker who is filling in for me next week, when I'll be in Philadelphia with my Canadian Travel Buddy, Pat.  Every day folks, I treasure and appreciate my ability to work and to enjoy my quarterly get-togethers Pat.  

Visit To My Urologist

The "Hobby Horse"

On Friday I visited my urologist for the first time.  This is the next step in the procedure to see if I have prostate cancer.

If you'll remember, a couple of months ago two consecutive blood tests revealed that I had a high PSA account.  While this doesn't necessarily men that I have prostate cancer it could be an indicator that I do have prostate cancer.  Thus, I had to schedule a visit to a urologist for a consultation.

My appointment was for 11:30 a.m.  Earlier in the day I got a call from the hotel where I work asking if I could work the 3 p.m. to 11 p.m. shift for my co-worker as well as the next day's 7 a.m. to 3 p.m. shift. This is a rough shift because of the short sleep time between shifts but I said "yes" like I always do.  More stress for the day.

I arrived at the doctor's office early hoping they would take me in early.  They did.

After I filled out the first time paperwork I was weighed and had my blood pressure taken.  Then I was given a funnel shaped device and taken to a bathroom and told to pee in it.  They would measure my urine flow.  We're off to a great start.

After that I was then ushered into another side room (lots of little side rooms in this doctor's office told to have a seat on the familiar padded table with the sheet of cold paper on it. I don't know what else to call it...a "hobby horse maybe?  Another assistant came in and asked me to life my shirt and T-shirt.  She smeared some cold jelly on my stomach and put a round cold piece of equipment on my stomach.  She was going to take a picture of my bladder (much the same way a pregnant woman has a picture taken of her baby in the womb).  Ambianosis or osmosis or something like that.  She greases me up and then slaps this huge gray, flat, round and cold stethoscope like piece of equipment on my six pack abs (yeah, sure).  She wanted to make sure I emptied my bladder from the urine flow test that I had just taken.  She finishes, wipe the grease off of my stomach and informs me that the doctor will be with me in a few minutes

Lubricant on the shelf - a sign of activity to come

I heist myself up on the hobby horse to await my fate the doctor.  In a few minutes time the doctor, who I had never met before let alone go out on a date, would get to know me better than 99.9% of the men I have dated in my life time.  I was about to get a digital exam (look it up).  I see the plastic gloves in the corner of the room at the ready.  OKAY.

The doctor came in, extended his hand for a handshake (the same hand that would soon perform another function on me) and introduced himself.  He was a young oriental man.  I'm not into orientals but I would rather having a man doing The Deed than a woman.  That's just the way I roll.  No offense to the lady readers of this blog.

Dr. Chang (not his real name) spoke clearly and thoroughly.  He made me aware of the recent news reports about PSA tests and asked me if I wanted to continue.  I said I did.  He then explained to me how the prostate is like an orange; soft and pliable. He said each person's body is different and that by whatever he finds by examining me doesn't necessarily mean that I have prostate cancer.

Gloves at the ready and The Stool 

He explained out the prostate gland work.  I won't go into the details but basically it is the gland that has a small tube running through it from the bladder to the penis so I can pass urine.  He said the cancer could be on the outside of the prostate gland in which case he could feel it.  However, he said it could also be on the inside in which case he could not tell be the digital exam which is was about to perform.  He also said that the prostate gland could be hard as a knuckle in which case that would indicate something bad.  But, if the prostate gland was soft and pliable as an orange, that didn't necessarily mean that I didn't have cancer, that it could be on the inside of the prostate gland.

The doctor gave me a white towel folder over twice and told me to "drop my pants" and to put the towel around my waist.  He left the room while I did this.  I dropped my pants. Surely not the first time that I've done this in my Life Experience but not under these cold, antiseptic circumstances. He would be back shortly.

I wasn't sure how much to "drop my pants" so I lowered them to my ankles.  I was in a bit of a quandary because I didn't want to go "to far" but I wanted to be accessible to the good doctor.  When Dr. Change (not his real name) returned there I stood with my pants (and underwear) down around my ankles (understandably I short circuited my chances for making a mad dash anywhere under these circumstances) with my towel securely fastened about my waist to secure some minimal facade of privacy.

I asked him "is this alright?" I think this is the first time in my life I ever uttered that phrase with my underwear and pants down around my ankles to another man I (or woman).  Oh well, there's a first time for everything.  Life is an adventure and mine was about to continue.

He said "Yeah, sure."  Then he uttered the phrase that all straight men fear ...."BEND OVER."

Thus the Digital Exam proceeded.  Oh wow.  Man oh man.  For what seemed like a LONG TIME, he stuck his BIG FINGER (didn't look that big when he put on the vinyl glove) up my You Know What.  He probed to the right, then to the left, then a massage of the prostate gland itself.  I could tell he's done this before.  He was VERY EXPERIENCED.  All I could think of besides when was he going to get his finger out of my ass, was WHAT A WAY TO MAKE A LIVING.  When I was in grade school my little friends would dream of becoming a policeman, fireman or astronaut.  I wonder what the Good Doctor dreamed of?  I'm going to grow up and make a living sticking my finger up in someone's ass?

The exam was very uncomfortable for me.  My back end is for EXIT only, and not ENTRY.  That's just me.  You know what I mean?  EXIT...yes.  ENTRY....no.  Well, at least he wasn't wearing any rings.

I couldn't help myself but I kept clenching. For a few seconds I expected to hear the Good Doctor utter those words "just relax."  Oh please doctor, don't say those words.  He didn't.  Thank you Jesus.

Then I worried that he couldn't get his finger out because I was clenched down too hard on it.  Am I telling too much here?  Perhaps.  I'm trying to keep this a concise as possible.

Finally he finished and removed his finger with what sounded like a "Pop!"

He told me that he couldn't find anything on the surface on my prostate gland.  That was good news.  He also said that my prostrate gland was soft the way it should be and not hard like a knuckle (which he showed me by forming a knuckle on his own hand).  He said that was good.  But then he said that my PSA "Freewill" (I think that's what he said) score was only 5% and it should be 25% or more.  He then asked me if I wanted to get a biopsy.  I asked him what that entailed (no pun intended).

He said he would do it in office.  He would take twelve biopsies which is twelve little chunks of meat from my prostate gland removed by some pincer like apparatus he has in his office.  Last Sunday I talked to my cousin Bud who is the same age as me and he had it done.  He said while it is "no picnic" he had it done.  I told the doctor I would have it done.

Thus I now have an appointment December 19th for have my in office biopsy performed.  Sort of like my Christmas present to myself.

So that's where I stand now folks.  No cancer detected yet but the PSA scores still are indicating something is amiss.

I went to work that afternoon and then yesterday morning.  When I left work yesterday I was exhausted.  The hotel was full and the many of the hotel guests needed attention. How do you pronounce "Lewes"?  "Lewis or Loose?"  Oh yes, I do more at the front desk than provide a dazzling smile and pleasant banter. I'm a Jack of All Trades.  At least I didn't have to deal with the wobbly toilet on the third floor.  Mike (the manager) took care of that.  I don't do toilets.

I have off now until next Wednesday unless I get a call to come in again to fill in for one of my co-workers who has the vapors. So that's the deal folks.

Updates as I learn them.

A Visit to the Urologist

Okay boys and girls, here we go again. I had another appointment at the Wilmington Veterans Administration Medical Center this morning. That meant rising out of a deep slumber this morning at 4:30 am. Oh how I love getting up at that hour. I couldn’t sleep anyway, knowing that I had to get up that early.

The American Legion Post 29 van picks me up at Routes 5 and 1 (just up the road about three miles) at 6 am. I was there about 20 minutes ahead of time. I wouldn’t want to miss my ride. The van arrives about 10 after 6. Just the driver and another old grizzled vet like me are going up today. The trip up was uneventful. In fact traffic was light. We arrive at the “city on a hill” (the way the VA building looks in the early morning sunlight just off of Rt. 141.) First thing upon entering the lobby, I have to scan my VA card. Yes, it confirms that I am 67 years old (you have to put your age in the computer to verify you are who you are) and have an appointment with the urologist today. My appointment with the urologist today is to go over the results of my CT-RAD scan of last Wednesday. That was when I had the dye injected though my blood stream by an IV injection.

The result of the CT-RAD scan is that I do have a renal calcli (that’s a kidney stone to those of you who haven’t had the “thrill” of passing one.) The good news is that it is small, only 4 millimeters. The bad news is that I will probably pass that kidney stone sometime during my lifetime. That’s a day I’m not looking forward to.

However, there is another interesting development. Since I passed blood the night before I passed my kidney stone (January 2, 2008 – oh I remember the night and following day WELL), the doctor felt obligated to advise me to get a procedure done that I was dreading. I’ve never been subjected to a catheterising before. That’s one bullet I’ve dodged. Well, the good doctor advised me to get a cystoscopy. What is that you say? Uh, it’s a small camera (yes, a camera) on the tip of a flexible tube (yes, they tell me it is very flexible once it is all greased, er, lubricated up) and inserted in my penis to take a picture of my bladder. They’re looking for a tumor which may or may not be cancerous. Here’s the problem. My brother had this done by a doctor who wasn’t really paying attention and the doctor punctured the wall of his urethra. My brother ended up in the emergency room because his blood was clotting in his urethra. Oh, did I mention he told me it was EXTREMELY painful. He said it felt like he had a lightening bolt hit him between his legs. He said he did not know such pain existed. He thought he hit the ceiling.

Needless to say, I expressed some reluctance at receiving this procedure after my brother’s experience. However, the good doctor was not to be swayed. He called in reinforcements. The head urologist came in and explained to me that the whole procedure, while not “pleasant” would take a total of 20 minutes, only 3 of which I would have the “flexible” tube inserted in my urethra. He explained to me that this is their standard procedure when there is blood in the urine. Now remember, I haven’t had blood in my urine since the night before I passed my kidney stone on January 3rd of this year. It is my understanding that blood in the urine before passing a kidney stone is a classic symptom. Now I understand why the doctor wants to check but I’m wondering, is this really necessary? Of course I don’t want to take the chance of being injured. As far as modesty goes, that’s been out the door a long time ago with my visits at the VA. A lot of them at the facility know me very well. In the ten years I've been using the VA facilities, they’ve seen everything. And I mean EVERYTHING. There is no corner or cubby hole of me that has not been examined, poked, or exposed to many and varied eyes of both sexes. I have no secrets. I'm an open book.

So here is my dilemma. Do I have the cystoscopy or not?

Just to end a perfectly beautiful day, on the way back to Slower Lower (Sussex County) in the van, we encountered a traffic accident on the other side of Dover. We sat in traffic a good hour and a half until we were directed to go back. Thus, the three of us took a meandering tour of the western side of Route 1 until we could connect to Route 1 again in Milford. We saw parts of Delaware we did not know existed. Delaware is such a small state, everything pretty much looks the same. Flat land, big chicken houses, WalMart trucks heading north and south (lot of WalMart in Delaware), and the big sky. Nice tour but we were all anxious to get home. You can't get lost in Delaware. Route 1, 13 and 113 run the length of the state. The other roads like Rts. 9, 16 run east west. Sooner or later one of those roads intersect with the powerful Route 1.

During our unexpected detour,I had plenty of time to think of “should I or shouldn’t I?” Originally they were going to schedule my appointment for December 24th. What a perfectly lovely way to spend Christmas Eve. No thanks. I reschedule it for January 29th, 2009. After I got home I called my brother (he lives in South Carolina) and told him of my situation. It brought back a lot of painful memories for him. He said if it was him, he wouldn’t have it done unless there was something wrong. I’m not passing blood now so, technically, there is nothing wrong. But, I’m still undecided.

While I was up at the VA today I had both of my computers on. I was transferring some of my 25,000 plus pictures from my old computer to my new computer. In those 25,000 pictures I have a lot of different people, places, and scenes. However, there is one picture I don’t have. If I do decide to get it done, you can be sure that will be my “picture of the day”. You might want to take the kids out of the room when you pull that one up.