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Saturday, July 25, 2015

Prostrated by my Prostate!

I’m not travelling at present, but I’ll be still posting some of my greatest “hits” for a while.  Right now I’m sitting at home recovering from a prostate operation: not for prostate cancer – but the other one – the one that guys don’t want to talk about, BPH – or Benign Prostatic Hyperplasia.

Basically BPH is caused by an enlarged prostate that cuts off the flow of urine from the bladder.  According to the Hopkins Medicine Organization, the condition is called BPH, or Benign prostatic hyperplasia.
“Benign prostatic hyperplasia (BPH): An age-related enlargement of the prostate that isn't malignant. BPH is the most common noncancerous prostate problem, occurring in most men by the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary stream; urgency with leaking or dribbling; and frequent urination, especially at night. Although it isn't cancer, BPH symptoms are often similar to those of prostate cancer.”

There are several treatments for it:  it can be able to be treated with drugs or several surgical treatments.  The most common treatment is called TURP or Transurethral resection of the Prostate – or as my late uncle Alfie used to call it, “The Ream Job.”

This is an operation a lot of guys need - but don’t want to admit– or even discuss.  After all we are we basically view ourselves just an extension of our dicks:  anything that reflects badly on our penis reflects badly on us.   I don’t know of any organ in the human body (including the vagina) that has more nicknames attached to it:  member, cock, dick, dink, pecker, peter, prick, putz, tool, Johnson, schlong, willy, wood - to mention just a few of the common ones.  If you want to get more esoteric consider: ankle spanker, one eyed snake, burrito, bratwurst - or my personal favourite, ding dong McDork.  We’ve all heard the term “pissing contest,” well it’s hard to have a pissing contest when you can’t hit the end of your shoes.

It’s not so much having the actual operation; it’s the run-up to the operation that’s the problem.  It’s bad enough just having your prostate checked - the finger up the butt - but if you actually need something done to your prostate it’s how they’re going to get there – and that’s through your penis.   As the saying goes, “Getting there is half the fun.”   Let’s face it, guys like to stick their penis into things – they don’t like having things stuck into it – and therein lies the rub. (Sorry - couldn’t resist).  Guys won’t even to talk about a TURP.  As my friend Larry says, the very thought of it makes him nauseous. 

But after a while questions quietly come up….  “So what are the symptoms?”  I had all the classics:
1.        Problems getting a urine stream started.
This is usually standing in front of a urinal or toilet for prolonged periods of time waiting “for something to happen.”  In my case, I was in the bathroom so long when I came out my grandchildren failed to recognize me.

2.       Having to urinate frequently at night.
We’re not talking about once or twice a night – but hourly.  You can actually see where I’ve worn a trail in the carpet marching back and forth to the bathroom.  Coupled with item 1 above means you barely get back into bed when it’s time to go again.

3.       Dribbling after finish urinating.
In this case a little rhyme is in order:
“No matter how much you shake your peg
Some always drips down your leg”
…or on the floor in front of the toilet.

So when you finally have had enough you screw up your courage and go and see your friendly urologist (try and pick one with thin fingers) you figure the worst thing that would happen would  be “the finger” – but I was wrong.  He actually wanted to have a look at my prostate. 
“…and how are you going to do that?” I asked.
“With a cystoscope,” he replied.
“Is that like a telescope?” 
“Sort of - it’s a camera on a long tube we insert up your penis….”
 At this point I put my hands over my ears and began to chant, “La-la-la-la-la-la-la-la”

It’s like a colonoscopy, where they shove a camera up your rear end on the end of forty miles of cable.  Except this time it’s up your penis which, in most of our cases, is a much smaller orifice.

I duly show up at the hospital for the cystoscopy which should take about ten minutes– a very LONG ten minutes!
“Do I get an anesthetic like I received when I had the colonoscopy?” (Which I mercifully remember absolutely NOTHING about.)
“Nah, it’s not necessary,” my cheerful urologist replies. “We’ll just spray a little local anesthetic on the end of your penis.  You won’t feel a thing – maybe a little pressure – that’s all.”
“Have you actually had this procedure yourself?”  I ask skeptically.
“No,” he admits.  “But everyone tells me it’s not that bad.”
“Perhaps we should wait until you’ve had it done.”  I suggest.
“You can watch the whole thing on TV right over there,” he says, pointing to a huge TV monitor off to the side.
“I would prefer to watch something else.  Do you have any movies? Maybe Fantastic Voyage?”  (That was a movie about a bunch of doctors who were miniaturized and inserted into a human body.  But if I remember correctly it wasn’t through the penis.) Not many movies have urologists and proctologists as heroes – and rightfully so.

Before I can protest further I feel something moving up my penis!  It doesn’t hurt, but it’s mighty uncomfortable!

“You might feel like you have to pee,” the doctor advises as he shoves another ten meters of hose in. 
“Also it might help if you try and breathe,” He suggests.
“Just a little further to go…. HOLY COW!!!!!!” he shouts.
 I nearly jump off the table. “What is it?” I gasp, fearing the worse.
“You have the Mount Baker of prostates!  Look at that!
“I don’t want to look.”
“You really should!  It’s incredible!! The only thing missing is snow!”
“I’ll take your word for it.”

With the sightseeing tour completed the “dink-a-scope “(as I have named the device) is retracted in a manner similar to pressing the button on the top of your vacuum cleaner and watching the cord whip back into the machine.

“We’re definitely going to have to do something about that,” he says rubbing his hands.  “There are a couple of options:  one is to treat the condition with drugs which might shrink the prostate – the other is surgery.  The downside of the pills is that once you start taking it, you have to continue taking them forever.  Since I’m already on some daily medication it’s a no-brainer – opt for the pill.

The pills seem to be working on most of the symptoms - but not the frequent night time visits. 
“No problem,” he says.  “We’ll give you some terazosin for that.  It’s an alpha blocker that use to be prescribed to lower high blood pressure.  The side effect is it causes you to pee more.  Sort of like Cialis – except you don’t get an erection.”
“Is that such a bad thing?” I ask.

The two pills seem to be doing their thing, but another problem arises.  I’m getting heart palpitations and I’m so fatigued that I can’t even walk a block.  I fear it’s my heart acting up and make an appointment with my family doctor.

“Is there any chance it could be related to the terazosin the urologist gave me?” I ask.
“No, impossible.  It’s probably your heart.  You better see your heart specialist.”
The heart specialist sees me almost immediately.  I explain to him my symptoms.  He seems concerned.
“Could it be the Terazosin?” I ask.
“No way.  We better get you scheduled for a stress test right away.

A few days before my stress test I have a scheduled appointment with my urologist.    I don’t get half way through my spiel when he interrupts me.
“It’s the terazosin,” he states. “It’s very rare, but I’ve seen a couple of cases of it, and you’ve got the classic reaction.  The good news is if you stop the medication and you’ll be back to normal in a couple of days. “
“…and the bad news?”
“You’re allergic to alpha-blockers which rules out using any pills to control the symptoms.  Your only option is an operation.”

Now I have a confession to make:  this isn’t the first time I’ve had the “operation,” nor the second – nor even the third!  It will be the fourth time!  The problem is the prostate is the dandelion of organs.  Cut it back and it just grows back stronger.   Normally the prostate is the size of a walnut – my urologist proudly tells me mine is the size of a small watermelon.

He promises to do a much better job than my previous urologist (who bore a striking resemblance to Groucho Marx – which might have been the problem.) 

The operation is preceded by the mandatory bloodwork and ECG along with a meeting with the anesthetist  who wants to know if I have  any concerns he should be aware of.
“Two,” I state. “First of all I would like to not wake up during the operation.  This happened to me on one of my previous operations and it was very disconcerting.”
 “I can see why you might find it upsetting,” he replies.
“Not for me -for the doctors. 

(Fade back in time to the operation)
“Hello!” I shout when I realize I am awake.
“Do you hear something?” one of the doctors asks behind a screen at the lower end of my body?
“Could be my iPod,” one of the nurses replies.
“No.  It’s not your iPod,” the doctor replies
 “It’s me – the patient.  Up here at the other end,” I shout. “I’m awake if anyone cares. I’m not just another pretty penis with a face.”
Suddenly a mask is shoved over my face and I mercifully fall asleep again.
(Ripple effect back to present time)

“That sometimes happens,” the anesthetist replies when I finish recounting my story.  “We give you a spinal so you won’t feel anything below the waist.  Some people prefer to be awake for the whole procedure.  They find it interesting.”
“I’m not one of them,” I retort.  “I prefer to be asleep for the whole thing.”
“Duly noted,” he replies. “And what’s your other concern.”
“That I wake up when it’s over.”

A week later it’s operation time.  My wife escorts me to admitting like I’m a kindergarten kid going to school for the first time. 

An IV is inserted into my arm and I’m given something to make me comfortable.  I’m asked to sit up and bend over to make it easier for them to jab a needle into my spine.    Before I can ruminate on this further the anesthetist injects something into the IV and I’m off to la-la land.

The next thing I remember is being awakened by a nurse asking me if I can wiggle my toes.  Mercifully I can.  As I become more awake I notice the catheter running from my penis.  It’s connected to a maze of clear tubing – sort of like a divided super highway.  One branch runs down from an IV bag into me and the other runs into a bag in a pail.  The highway interchange is right at the head of my penis.  It’s not painful -just uncomfortable. 

I’m in co-ed room with four other people who are mercifully quiet – unlike one of my previous visits where the room was populated with wack jobs who moaned and screamed all night, till I contemplated putting them (and me) out of their misery with a pillow.  Fortunately (for them) I couldn’t figure out how to smother them while still hanging onto my IV in one hand and the catheter in the other.

Every hour or so a nurse replaces the empty bag on the IV pole with a fresh one, and empties the bucket.  Around midnight one of the nurses comes in and shut-off the waterworks and tells me if things look good they’ll remove the catheter in the morning.

Here’s a hint for you:  never – I repeat, NEVER – let a student nurse remove your catheter.  I’d rather let them perform unsupervised open heart surgery on me than remove my catheter.

During one of my previous visits I was asked if I minded letting a student nurse remove it.  I agreed figuring she needed to get some practice, and what could go wrong.

There are two parts to inserting the catheter.  First it’s insert then a bulb inside is filled with water to seal it and insure that nothing dribbles out and everything goes out through the tube.  When it comes time to remove the catheter they first drain the bulb.  My student nurse must have missed that part of the lecture.  When it came to remove mine she must have thought she was starting a chain saw.  My nail marks are still in the ceiling tiles.  So no more student nurses for me.

After the catheter is removed they want to insure you can pee okay before sending you home.  At the previous hospital they placed jars in the bathroom with our name on it.  There was a red line about three-quarters of the way up the jar.  When you’d peed enough to reach the red line you could go home.  One of my roommates was a “peeing machine.”  Every few minutes he’d retreat to the bathroom and return with a smile on his face and give us a progress report.  I wasn’t doing as well.

After his fifth visit he proudly announced he’d reached the magic mark and called for the nurse to verify his accomplishment.  While he was waiting for her to arrive I paid a quick visit to the washroom.  The nurse arrived shortly after. 

She returned from her inspection of the jars and announced, “Well Mr. Groberman, I see you can go home now.  Well done.  We’ll call your wife to pick you up.”

“Excuse me,” my roommate interrupted, but what about my jar?
“I’m sorry, sir.  You’re only halfway there.” 
I smiled at him as I gathered up my stuff.

It takes a little longer this time without “help”; but around noon they call my wife to come and collect me.  I have been in hospital 24 hours.  Now would come the part I dreaded more than the operation: the recovery.

The recovery usually takes three or four weeks.  Based on my three previous operations there is an initial week where you don’t feel too bad – other than the “dance.”  The “dance” is caused because the urethra – the tube that carries urine from your bladder - is irritated from the procedure (and rightfully so!).  You experience its displeasure as a burning or tingling sensation when you pee.  This discomfort is accompanied by hopping from foot to foot or, in extreme cases – running on the spot. The good news is that this sensation usually decreases over the first couple of weeks and the dance becomes more of standing on your tip toes at the beginning and ending of each pee.  By the end of the third week the dance is over.  The “dance” is sometimes accompanied by the “blood thing” (An actual medical term).

The “blood thing “can be a bit disconcerting:  I don’t like blood of any description coming from any of my orifices at any time.  Unfortunately this is not possible when you have a TURP.  When you’re in the hospital you’ll notice that there is blood in the catheter tube.  Usually when they send you home there is the fluid in the tube is clear.   When you get home you may notice that the pee in the toilet is a faint pink color.  That’s normal.  There may even be a drop of pale blood when you begin and end peeing.  This comes and goes.

However don’t get complacent about the relatively nice clear stream.  Somewhere around the second week you’ll notice you will start to pass clots (just when you thought you were over the whole thing). It’s a weird sensation when these pass – not uncomfortable – just sort of weird. 

The scariest time is around the third week when most of the scabs seem to come off.  You’ll be passing a bunch of these things – again with some diluted blood.  This usually lasts a couple of days.  I’m usually panicked at this time and on the verge of calling the doctor.  But (again based solely on my experience) this passes and in a day or two- and congratulations - you’re on the other side of the whole thing - the worst is over.   There may still be the odd small clot or two that passes and by the end of other two or three weeks you should be 100%.

Is it worth it?  I think the short term discomfort is worth the results – most guys agree.  And besides, my new urologist  is guaranteeing me ten years on this job and I don’t have to keep wiping off my shoes.

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