At least they're not condoms

There are aspects of prostate treatment that I haven't talked about...until now.

As one approaches most of the treatment options, one begins to plan for the post treatment effects mentioned by physicians and in the literature. For most these include incontinence and impotence. The hope is that these will be temporary lasting from a few days to a few months...or more than a year, but temporary.

While impotence is nothing to look forward to, it is not something that should cause spontaneous embarrassment at awkward public moments...unless your life is a whole lot more exciting than mine. Incontinence, however, needs to be planned for to avoid public exposure..."Ummm, Bill...why is there a puddle growing beneath your right foot?"

In anticipation, I decided I should stock up on necessary supplies before the surgery. I was advised to not go for the generic or store brands, but to go top shelf...Depends.

But going to the store I found myself walking quickly by the display, not even looking for any length of time for fear someone would think I was shopping for me.

"Holy crap, this is just like trying to buy condoms when I was a whole lot younger." I thought, "And that's just stupid. I'm an adult, shopping for a medically necessary product for a procedure I'm going to have soon. I have every right to buy Depends and not be embarrassed, I have every right to purchase what I need without public humiliation. Depends are on the shelf for people to buy. It's time to grow up."

So I got back in the car, drove home and asked Lucia if she'd buy my diapers. She did.

As I mentioned in an earlier post, ultimately I experienced zero incontinence...but I wore the Depends (now available in sporty gray as well as white) for several weeks until I was confident I was in fact in control. Then I decided I should at least wear a pad for a while...just to be sure. So I went online and found that Depends also make a pad for men, "Guard."

This time, however, I steeled myself and went boldly to the store, walked directly to the display, located the Guards, took a package from the shelf and took them to the cashier...all by myself (I'm a big boy now!).

OK, I did sort of hide them as I walked through the store, but I did it! And I even resisted my inclination to say something stupid to the cashier like, "If my father doesn't like these, may I return them?" Nope, kept my mouth shut (no small task for me).

This is one of the aspects of treatment I had not anticipated, but I find there are many things I am learning about myself as a result of the surgery...and that's a good thing.

Now I think I'll go buy some condoms.

I'm not qualified

This will be very brief because, as noted above, I'm not qualified to discuss this in any depth.

When one is diagnosed with prostate cancer the education process goes into hyperdrive as one explores the disease, the disease process, treatment options and more. One statistic I found interesting from one author was 90% of prostate cancer can be attributed to diet.

While I have found arguments on both sides of the issue, there seems to be enough support for the dietary connection (correlation?) to warrant further study. From a personal perspective, my diet BL (before Lucia) was generally inadequate and loaded with everything I now read provided a heavily greased runway for cancer, heart attack, stroke, high blood pressure, lupus, dandruff, bad feet, enlarged ear lobes, and hair loss (not really...just threw that last one in).

In talking with doctors during my prostate cancer journey, no one would claim a definitive dietary connection, but most suggested our consumption of wheat, dairy products, and sugar seem to be contributory.

A bit too late, we have eliminated most wheat from our diet (there really are some excellent alternatives), never used much dairy, and we avoid as much sugar as possible.

I'm reading more about vitamin/supplement support now, but it's going to be a long time before I will feel comfortable commenting on that subject. But I certainly welcome opinion and information from others.

In fact, as I continue my education I welcome comments to assist my understanding of all matters nutritional.

I have not had a baby!

Five weeks and two days after surgery I'm spending my second full day at work and feeling pretty good. However, I was reminded last evening that I've still got recovering to do.

During a conversation with Lucia over Manhattans and hors d'oeuvres, I happened to say something I found incredibly funny (I often think I'm one of the funnest people I know)...anyway, I began to laugh heartily and, for the first time, suddenly leaked! Not much, just a few drops, but enough for me to notice. I was stunned; I had expected to experience some exercise induced leaking when I resume running in a few weeks...but not laughing!

I have been doing so well in every area of recovery. Thought I had all the bases covered until, as Roy Clark sang (sort of) "A little bitty drop let me down." Guess I'm gonna break out the pads for New Years Eve as I expect to be hysterically funny that night.

Lucia's response, intended to make me feel better, was to assure me that every woman who has had a baby occasionally leaks when laughing or sneezing (Oh shit, you mean this could happen when I sneeze?). Obviously it was not exactly what I wanted to hear.

Because I had, up until this moment, been waayyyyy ahead of schedule I had stopped the Kegels (restarted those immediately), stopped the Viagra (hand me that little blue pill), and decided I have had enough rest.

I needed to be reminded of the impact of prostate surgery, and the importance of not taking shortcuts to recovery. A trauma has been experienced, and I need to respect the healing process...all of it.

What the heck, maybe I'll just be mildly amusing New Years Eve...naw, I really get a kick out of me. Besides, I have not had a baby, dammit.

Yoda Knows Best

Yesterday I ran into a friend whose husband recently died of prostate cancer. Once again she expressed happiness at my progress...progress her husband did not have the opportunity to enjoy. Actually, that's not accurate, he had the opportunity, but chose to ignore the problem until it progressed beyond the point of treatment. His choice was not "watchful waiting"...it was simply waiting.

If these ramblings have any theme it is this...prostate cancer, detected early, affords one a wide variety of treatment options, all of which boast records of very positive outcomes.

Yoda said it in Star Wars Episode V, "Try not. Do or do not. There is no try." Trying implies less than full dedication to the outcome...this is life we're talking about here, it deserves one's best effort.

While it is still way too early for me to report on the ultimate outcome of my treatment, I can't imagine being diagnosed two and one-half months ago and still not having made a treatment decision. With so many options available, one might argue the wisdom of my choice...but acting upon a choice (even if it's the choice of watchful waiting) is the first step toward a cure.

I don't want to meet any other friends deprived of Christmas with a loved one because of something as responsive to treatment as prostate cancer. Bend over, smile, and know you're doing it for those who love you...then, if something is detected, "Do."

A quick observation

Prostate cancer, like any other serious illness, tends to focus one's attention upon that which is truly important in life. This year the blessings of good friends and loved ones easily eclipsed the more commercial aspects of the holiday. While I have intellectually understood this for a long time...this year my understanding is visceral.

May you all find peace, love, and friendship.

We have liftoff!

This story really began Tuesday evening when I decided to forgo the prescribed Viagra regimen. Imagine my delight on Wednesday, four weeks after my November 21st surgery, and Thursday when Milestone #6 moved into the accomplished column! That was an unexpected early Christmas present.

I've decided to wait until next week to resume the therapy and see if there is any change in this uplifting development...a firm decision.

The miracle here is the precision possible with the da Vinci robot in the control of an experienced surgeon. The name "nerve sparing surgery" is not just marketing.

When I chose to go the surgery route, I did not anticipate such a positive outcome with respect to incontinence and sexual function. While recognizing not everyone can expect the same result, I have become an active advocate of the treatment choice if it is appropriate given the cancer/patient profile.

Having an old friend back in my pants...oh wait, that sounds wrong. Resuming an important part of life does much psychologically for continued recovery. Today, I have only one area of concern...that being one of the incisions which does not seem to be healing like the others (looks a bit angry)...but I'll give it some time.

I identified six milestones in the evolution of my prostate cancer, and I was prepared for the journey to last from several weeks to several months or longer (perhaps much longer). Having past all six before fully recovering from the surgery (still tire easily), I feel truly blessed in this season of miracles. Gotta establish additional milestones!

Now, let's see what else I'm up for................

Patience is a Virtue

After four and one half weeks of recovery and hearing, “Just be patient, it's going to take time for you to get back your endurance, your energy, etc.,” I'm sick of this. Although I feel my recovery is not only on schedule but even ahead of schedule (stay tuned for a big announcement tomorrow), I have to admit I'm growing more and more impatient with each passing day.

Patience is a virtue...get me a bucket! I'm doing everything I have been told to do but the incisions still hurt, I still tire easily even though I take several naps daily, and if I sit for long periods of time I feel pains in places I didn't even know I had before the surgery.

I have never had an extended illness, nor have I had surgery, and I've always been a quick healer. Intellectually I understand the trauma my body has experienced, but emotionally I just want this all behind me.

Yesterday I tried to put in a full day at the office...made it from 7:00am until about 3:00pm before I had to give up and head home to the couch upon which I've been living for the past month. Today is slightly less ambitious with plans to be here from 8:00am until about 2:00pm...but there is so little to do at home.

Thanks to the internet, I can stay in touch with business partners and activities from my couch...but it's just not the same. I play well with others; alone, I'm a mess.

Patience is a virtue because it's so damn difficult, and that's one of the greatest challenges as we recover from our chosen treatment. We have to give our bodies the opportunity to renew. Be good to yourselves and (buckets up) “be patient.”

Christmas Tie

I only have one nice Christmas tie...I also have one stupid Christmas tie (the kind with the funny Santa and his reindeer). Anyway, I didn't think I was going to have an opportunity to wear either this season...until today(and neither one will do me any good next week).

This morning I decided I'd try working an entire day for the first time since the surgery...unless I get too tired. A 7:30am board meeting presented an opportunity to wear real business clothes for the first time in a month. So out came the dress shirt (haven't tucked-in a shirt for a month), the classy Christmas tie, nice slacks with a belt (which I also haven't worn in a month), and jacket.

Lucia often says, "When you feel your worst, look your best!" Well, I don't feel my worst, but dressing certainly has done a lot for my attitude and I believe I even have more energy. Once again, Lucia knows best!

I have much for which to be thankful this Christmas season...indeed, I have received more than my share of blessings during my journey with, and without, my prostate. May your holiday, whatever your tradition, be filled with love, laughter, and health.

I continue to receive messages from readers. This morning I received a note from a twenty-five year old asking questions regarding prostate health not just for himself, but for his brother and father as well. Perhaps the message is starting to be heard.

New insight...well, expanded insight

Yesterday I had an inspired thought (a rarity for me). Why not promote my blog on sites with a primarily male audience since I'm trying to expand discussion among men? Logical...duh!

So I posted on the three primary gun owner sites I frequent. I received a great number of responses and traffic on the blog skyrocketed. I heard from a number of men who had been diagnosed who reported on their treatment decisions and post treatment experience.

But the insight came from those responses that detailed colonoscopy results finding polyps, but no prostate problems...others private messaged me to ask me what a prostate does and how it is checked.

We have a lot of educating to do. These were not dumb men, simply men who had never received any information regarding prostate health...which is sad in light of the position prostate disease ranks among men.

Please talk about the issue with your friends, sons, sons-in-law...OK, not around the Christmas dinner table, but when the opportunity presents itself. There are a number of good websites on the topic I'll publish at a later date; and if you know of good websites, please let me know so I may add them to the list.

Yet another killer we can stop with education and early detection.

Happy 4th...

Today marks the fourth week since my surgery, and I mark the anniversary with a realization that I've come a long way from November 21. Endurance continues to improve daily, and I'm beginning to feel like myself once again.

In an unrelated phone call this morning, a young lady told me she enjoyed reading this weird blog. Hmmmmm, I originally began this to assist men facing prostate disease, and to increase awareness of the need for men to discuss prostate health openly, honestly, and frequently. It never occurred to me women would find the subject of interest...this, of course was short sighted on my part.

Prostate cancer and other prostate health issues affect more than just the man who's body happens to houses the offending tissue. As Ken Jones so often reminds us, prostate cancer affects the wife as much as the husband...Lucia enthusiastically agrees.

Then there's the matter of women just being better about monitoring their health than are men. Perhaps it's our macho coming out, but I think it's more likely denial and fear that keeps men from seeking medical attention when we know something just isn't quite right. "It'll be better in a few days,I don't want to bother the doctor." is often our fallback position. We're also cheap.

Ladies, keep us honest and force us to talk about our health. You express your concern for prostates and we'll express an interest in boobs...oh yeah, we already do that but it has very little to do with matters of importance. Maybe we'll grow up some day.............................naw.

I can see light at the end of my recovery...it's still a way off, but I can see it. I'm glad I didn't ignore the problem, or postpone treatment; and Lucia was integral in keeping me focused on dealing with it. Once again I discover we have a lot to learn from the women in our lives just as they keep telling us (over, and over, and over again).

PS Keep those verses coming for the song in the previous post...you know you want to!

To the tune: "Walking in a Winter Wonderland

Prostate's gone, I was freakin'
'bout how long, I'd be leakin'
Today look at me...incontinence free
Walkin' 'round in Big Boy Underwear

Now, all y'all (the proper plural of the singular y'all) submit your own verses.

Milestone #5 BBUD

At the risk of speaking too soon...tomorrow I plan to celebrate the fifth of the six milestones I identified earlier...that being BBUD "Big Boy Underpants Day."

From the day my catheter was removed, November 30, 2011, "a day that will live in infamy," I have been wearing Depends in anticipation of the post prostatectomy incontinence referred to in all the literature and during doctor's visits, incontinence expected to last from a few weeks to more than a year.

As I mentioned in another context, my experience is peculiar to me and cannot be generalized to any other patients. Yesterday the doctor asked me about incontinence and I was able to tell him that, to date, I have not had any leakage...not a drop! I expect there may be an issue when I resume running in a few weeks, but in normal daily activities (or as close to normal as the recovery period can be) I have had zero, zip, nada.

With no medical knowledge upon which to base my opinion, I attribute this remarkable record to three things...the skill of an experienced surgeon, the unparalleled precision of robotic surgery, and the fact I started the Kegel exercises several weeks before the surgery rather than waiting until after the procedure as mentioned in the literature provided.

This is yet another concern that haunted me prior to the procedure that has proven to be baseless. Again I urge men not to avoid treatment due to anticipated pain, discomfort, or problems...you can deal with whatever comes your way, but don't reach forward to borrow trouble.

And so tomorrow...it's Big Boy Underpants Day for me; leaving one milestone to go (see earlier posts).

Here's the point...

I received an email today from a friend who wrote:

"I keep pushing my Buddy, XXXXXX, to do something(Laser, Seeds or
Surgery) with his; but he is avoiding the Issue!!!"

I responded with a story of someone I know who took the same approach and ultimately lost what became a battle for his life. Of course, I also reported the gentleman I spoke with who has been monitoring his prostate cancer for eight or nine years and is doing just fine.

But with so many treatment options and such positive outcomes for each...why the hesitance?

Perhaps it is avoidance as my friend suggests. Doing nothing does take less time (duh), and there are no side effects (unless you consider potential death a side effect).

I did not have to choose surgery, and I did not have to have surgery so soon after being diagnosed. On the other hand, I am recovering quickly with improvements every day, and I can easily see the time in the not too distant future when the minor inconveniences I have endured will be only memories.

Surgery and radiation are indeed barbaric solutions to prostate cancer, but they are effective, survivable, and available now. Complications can, in all most all cases, be mitigated.

I understand anyone's hesitance and concern (or fear), but I would do it again in a heartbeat if I had it to do over again. I'm free of prostate cancer and I will be running again in a few weeks...what's not to like about that?

For God's sake...more importantly, for your family's sake and your own...do something, and do it today.

Can we talk...

I've mentioned it before, men don't talk enough about this stuff. It was amazing how many men came forward to talk to me after the diagnosis was made and I started seeking information.

My neighbor, from whom I have lived across the street for eight years, told me he had his prostate removed about ten years ago (when he was just 46). Another man approached me at a social and literally yelled, "Hey, I hear you have prostate cancer!" I affirmed his statement and he responded, "I had my first radiation treatment today." I congratulated him on taking action.

At the same social, a friend dragged her husband up to me and said, "Tell him...go ahead, tell him." The poor guy told me he had just received results of a PSA measuring 56. "Tell him he has to do something, Bill." she said to me. I spoke for a few minutes about my biopsy with the uncomfortable husband, then said we could speak at another time (this story has a happy ending in that his resulting biopsy found no cancer...now the question is, why the elevated PSA?).

Fellow Rotarians came forward to tell me of their positive results from seed implantation, others told me of how happy they were with open radiation...still more who had opted for surgery.

The point is, there is a wealth of experience and information out there that can be tapped if we are aware of it. That's what this whole stupid blog is about, just starting a discussion.

Just before my surgery, a friend suggested I contact a friend of his who has been living with prostate cancer for eight or nine years. I contacted the friend and was blown away. He had been diagnosed years ago with a profile much like mine. Unlike me, he had adopted a very aggressive campaign to find the best treatment...traveling all over the country, and beyond, to interview the creators of various treatment options and visit the top treatment centers. To date he has not found a treatment that provides him the level of confidence he demands. He regularly monitors his PSA and has regular (almost disturbingly regular) biopsies and, to date, the disease progression is slow and causing no problems.

"I know I might wake up some morning with a pain in my side and be told the cancer has spread beyond my prostate and is now a real problem," he says, "but I'm just not convinced they have a treatment that will guarantee I won't have complications."

OK, not my choice, but one that deserves to be heard and considered. If you have been diagnosed, treated, or waiting for treatment...talk about it with anyone who will listen, it will help you both. End of sermon.

Life after cath....

The most frustrating thing about recovery seems to be the time it takes. My lack of endurance amazes me as I have to stop so frequently to rest...but, rest from what?

The days are filled with time on the couch intersperced with naps and brief periods at the table eating while thinking how much I'd like to be back on the couch.

In addition to the surgical incisions, one can feel things happening within, and bleeding continues to remind me of the intrusion suffered.

Little to no pain to speak of...and I have experienced none of the expected incontinence (hard to be pissed off about that!). The nightly Viagra treatment produces the expected results indicating, to this medical novice, encouraging signs the nerve sparing surgery has been successful.

Increased walking each day and short trips to the store point to slow but continued progress...so, I'll rest, then rest more, and be satisfied with life at a much slower pace. But I have to be honest, I can't wait until Jan. 15 when I'll be OK'd to return to running (that ought to be a sight...my leg muscles have already atrophied to a great degree).

CFD...Catheter Freedom Day

Wednesday, November 30, 2011, will always be remembered as CFD for me, a day I had looked forward to since before the surgery.

Getting dressed, I looked forward to seeing the doctor once again and receiving recovery care instructions.

The drive was uneventful and could not have been at a better time to avoid all rush hour traffic. Arriving at Riverside, we found a parking place and I had to control my urge to run toward the doctor's office complex.

Note: for this special occasion I chose a simple black bag to conceal the cath
bag...I know, I know...black is for evening wear, so sue me.

Arriving at the office I was told the doctor's nurse would be taking care of me; oh joy, yet another woman I've never met getting physical with my wiener (which sounds like a good thing...it isn't). Oh well, by now I have lost all humility.

Kim comes into the treatment room and tells me to take off my pants and underwear and cover up with the sheet...then, she's gone. I do as instructed and sit on the table waiting eagerly to lose the tube.

When she returns, the first thing Kim does is remove the staples (which had concerned me but proved to be without discomfort) and cover the incisions with small pieces of tape she tells me will fall off in 7 to 10 days. Then, she says, "Lay back." Here it comes.

Here's the deal, the catheter is held in place by a balloon in the bladder. To begin the removal, Kim took a large syringe and deflated the balloon...at one point there was a sound (I think) and a definite sensation of something happening inside. Kim said, "Did you feel that?" Ummmm...yes. "That's the balloon. Now I'm going to fill your bladder with water." and she began to inject syringe after syringe of water into the catheter. Then she began to pull.

Holy Crap! I thought the catheter was around seven inches in length...WRONG! She pulled...and pulled...and pulled. My guess is about twenty inches, felt like forty. No pain in the process, not even the slight burning sensation Kim had suggested I might experience. I have no idea where all that tubing was, but I'm surprised it didn't interfere with my swallowing!

Next I was handed a beaker to collect the water that had been injected...which appeared to be mixed with an equal amount of blood. I was a bit concerned by the amount of blood, but Kim told me that was absolutely typical. Then she told me to get dressed while she got my parting gifts.

For anyone reading this in anticipation of surgery let me emphasize I experienced no discomfort throughout this process...my experience may not be typical, but my guess is most will be similar; there is nothing to fear.

When Kim returned, she had lengthy written instructions (time to begin those Kegel exercises) as well as prescriptions including one for 90 Viagra tablets (half a tab daily for six months) and one for a vacuum system; both to assist in the recovery of sexual function.

Then, thirty minutes after we arrived, we were walking out the door toward the car "catheter free!"

Now the recovery begins in earnest.

First week home

The first week at home was uneventful with the exception of learning to navigate through the activities of daily living with a four foot hose exiting my body and terminating in a bag. Peg the Wonder Nurse suggested I keep the bag inside a pillowcase to help avoid the possibility of infection from household dust/dirt (it also makes for a handy way to carry/conceal the bag).

Cleaning the catheter and entry point a few times each day are important to further avoid infection...something with which I never did become comfortable. But the fear of infection is a powerful incentive to do as instructed (I had this irrational fear that I might accidentally pull the catheter out...not a possibility, but that's the definition of irrational).

The solution I found to showering was to leave the bag outside the shower curtain on a small stool...then try not to pull it off during the shower. Lucia remained within an arms length whenever I showered as my balance was suspect.

Sleeping arrangements had to be found that would allow me to remain on my back (which I hate) to accommodate my incisions while allowing the bag to rest on the floor. We put a couch in the living room where I would spend the vast majority of time those first seven days.

Having never had surgery, I was amazed at how easily I tired and how much time I spent sleeping...it seemed like I napped every two or three hours.

My appetite was good and, thanks to not requiring any pain medication, I found wine to be a great treat with meals (could get used to that...oh, who the hell am I kidding, I've been drinking with my meals for years).

I did try to get outside to walk every day...not too far, and it was great to be out seeing neighbors and feeling compelled to explain the pillowcase I was carrying (I did not like the leg bag that was given to me at the hospital, too small and, thus, requiring maintenance too often).

No adventures to speak of during that first week at home, just waiting patiently for the day the catheter would be removed and I could return to life untethered.

ARGHHHHH...Insurance, Viagra, and me

To be fair, I haven't even begun to receive the big bills for my surgery and hospitalization...but the insurance company is already driving me nuts.

On the day I had my catheter removed (remember...CFD?) I was given two prescriptions, one of which was for 90 Viagra tablets to be split in half and taken daily for six months. Nerve sparing robotic surgery is intended to allow one to return to normal sexual activity and Viagra promotes vasodilation following prostatectomy to preserve function.

When I first filled the prescription, I received three tablets and a $60+ charge. I was a bit confused as I had fully met my deductible and all prescriptions were to be covered. Well, I got that fixed...the next refill was another three tablets, but at no charge to me. Returning for the second refill I was told the insurance company would not cover another refill until January 6, 2012 (surprise...new deductible year, so no pay then). I am allowed just three tablets per month once my annual deductible is met.

Calling the insurance company I plead my case...this is not "recreational" Viagra, this is medically necessary therapy following surgery to prevent complications (potentially very expensive complications for the insurance company); but my argument fell upon deaf ears. I'm filing an appeal, but expect no luck.

So here's my deal...I want to begin a Viagra Bank for prostatectomy patients. Here's the way it works: Every time we go to the doctor, we request a sample of Viagra...we then send those samples to someone in need of the therapy if they promise to do the same after their need is met.

Look, this is going to cost me about $1,800...ouch! If someone can get samples but doesn't need them, I'll take every tablet I can get and gladly do the same for the next patient. If insurance isn't going to accept the therapy as medically necessary, we can do this ourselves. Whadda ya think?

This is cool...

OK, the story just got me home from surgery on Thanksgiving day, and then I remembered what I forgot.

The surgery I opted for is a radical prostatectomy via da Vinci surgery, a robotic assisted procedure. What I forgot was to ask the surgeon if he had a video of either my or a generic procedure. Well, this morning I remembered I had yet to follow through on my interest, so I went online and guess what I found?

If you have an interest in things technical and surgical, below is a link you can follow to see a portion of the surgery. I have five "ports" in my abdomen through which arms of the da Vinci robot did it's work...you'll see three instruments in this video, and you're looking at the action through the same instrument the surgeon uses to direct the other "arms." Enjoy!

http://youtu.be/nPVP3NkaP44

Wed-Thursday...Home on Thanksgiving

After I concluded I could not go home, Tuesday evening through Wednesday evening was the most difficult time I can remember in my life. Wave after wave of nausea...not your typical, "Gee, I feel sick," nausea...but the kind where every breath was so painful I actually understood not caring what happened to me as long as the hurting stopped.

Poor Lucia tried everything to ease my discomfort only to have me repeatedly snap at her. I knew I was being unfair, but couldn't stop. I can never make that up to her, and I'll never forget her loving patience.

After vomiting several times, the nurses called in a gastrointerologist (never tried to spell that before, how'd I do?) to see me. He ordered x-rays to eliminate the possibility of physical blockage, then told me he would be back after supper with a team.

When he returned with his gut buddies, the head of the team thumped on my belly and said, "You hear that? Sounds like a drum doesn't it? That's gas in your gut, very typical in abdominal surgeries. That's what is causing the pain. If you can expel it on your own, that would be best...otherwise, we'll put a tube down your nose tomorrow and decompress it that way; you won't like it."

OK, let me get this right...I'm being told to fart and belch...ALRIGHT! I told the doctor I would not be needing the tube...and went to work.

I blasted away for an hour or so, then took a nap. When I awakened, the nausea was gone and never came back. I knew all my pre-teen fascination with farting (OK, never outgrew that one) would come in handy some day. It is an art, and now a medical technique, as opposed to the immature behavior mothers and wives claim.

I learned I probably caused the problem by accepting all the pain medication offered. The meds slowed the awakening of my bowel and exacerbated the gas problem. I never really experienced any difficult pain from the surgery itself and could have, perhaps, done with far less intervention.

Note to future patients: Take what you need, not more, and not what you want.

After the first annual "Sharp fart-fest," I continued to improve and was ready to go home Thursday after lunch...and before the tube team could return to my room.

Then it was getting dressed and walking down to the lobby, cath bag in hand, to head home. Home for Thanksgiving...I have much for which to be thankful; Lucia and I talk about that on the way home.

If I haven't mentioned it, the surgeon was a regular visitor to the room monitoring my progress. At least a few times each day, including Thanksgiving morning, he was there. I know I picked the right team for me.

Now recovery begins.

The second 24 hours

Most of Tuesday was eerily like Monday...without the surgery part. Felt good, little pain, and walking ever increasing distances. In the afternoon I was told I could go home after supper if I chose to do so.

I was so excited to go home...the staff was still too busy to spend much time with us, but I figured it would just be Lucia and me at home anyway, so as long as we could cope everything was as it should be.

After supper they delivered a goodie bag of a second catheter bag, leg catheter, and other home supplies (including a video we were required to watch on the care and feeding of the leg catheter...thrilling, but the lead character was weak).

The IV was removed...and blood went everywhere, but we soon got that under control.

I got dressed (we had to learn how to put pants on over the catheter) and the wheelchair arrived. Then, as I started toward the wheelchair, I was hit by a wave of nausea and had to stop the whole process.

"I can't go," I said, "I have to get back to bed NOW."

After a few moments of confusion and disbelief, everyone was on the same page and instead of getting in the car, they were restarting my IV. I have never felt so ill. CRAP, I wanted to go home.

In retrospect, I'm glad I got ill while still in the hospital. How much worse would it have been if it had hit me in the car on the interstate? And so, I began the next chapter of my post surgical adventure.

The catheter...a bag of fun

One is not intimately acquainted with one's penis until one has been catheterized. And that's just the beginning as, suddenly, a whole host of people (strangers and family) are exposed to that which makes us men and that which has, until now, been a relatively private possession.

Humility has no place in the hospital room. New aides and nurses rotate into your life with amazing speed and each wants to see the action. Then, they want to assist the person who will be assisting you at home in the care and feeding of what is quickly becoming a shrinking asset.

My job...sit and watch as the parade continues, knowing it's all to avoid future problems and infection. Then, everything changes.

A new nurse enters my room on Thursday (Thanksgiving and, hopefully, the day I get to go home) and I know what's coming...so I prepare to bare (bear?). OH MY GOD! LOOK AT THIS!! I throw back the sheet and raise my gown before the newcomer and ask, "Is this normal?" as I stare down at something the color of an eggplant with an appearance not unlike a partially deflated Goodyear blimp. Truly disturbing, I cannot avert my eyes...and my pulse has gone through the roof.

New nurse casually looks and merely smiles, "Yes," she begins, "I've seen all kinds of things. They get swollen, bruised, scrotums become bruised, sometimes the entire area of the groan becomes purple up to the navel." Then she yawns, pulls my gown down, and heads for her computer.

Soon, she and Lucia are cleaning the Frankenpenis (FP) as if nothing was wrong...but this is all wrong...very wrong.

Within several days, FP begins to calm down and is back to as normal as possible for something with a garden hose coming out of my body.

One actually becomes accustomed to the catheter, the required maintenance, and the need to drag the bag everywhere 24/7. And then, after eight or nine days, you find yourself on the way to lose the tube for good.

Now, back to the narrative.

The first 24 hours

The first 24 hours after surgery remain a bit of a sleepy blur...lots of sleep and images of activity around me. When awake, I actually felt surprisingly well. There was not the pain I had anticipated, nor were there any dreaded (put down your sandwich) bladder spasms I had been warned of as a result of the catheter.

The overriding lesson from the first 24 is: For God's sake bring someone with you if you choose surgery! You need someone to advocate on your behalf to an apparently overworked crew of nurses and aids...someone who hears what the nurses say to you and then insists they follow through...someone to ask the questions you're too groggy to ask...someone willing to learn the personal care routine and help you stay clean (something the staff seems uninterested in)...someone who cares for you rather than the computer charting...someone who watches everything happening. This is an important lesson...listen and learn.

We did take our first walk in the early evening after supper, I wasn't going to win any awards for speed, but I did not find walking to be painful (although getting out of bed was another story). I was surprised at how quickly I tired. Returning to the room, one of the younger nurses showed me how to get back into bed without pain; a good skill to learn early in the hospital experience.

Next up...catheters, a whole bag of fun!

Urgent: A special announcement

We interrupt this story for this very special announcement.

Today is CFD, the fourth of six significant occasions in my prostate's evolution. CFD = Catheter Freedom Day. In just a few hours, I travel to Columbus to lose the tube.

The six significant occasions:

DD = Diagnosis Day
TDD = Treatment Decision Day
GOD = Grand Opening Day (if surgery is right for you)
CFD = Catheter Freedom Day

The above are backed by research and experience...what follows is theoretical, but I will report at each milestone.

BBUD = Big Boy Underpants Day
MBBD = My Boner's Back Day

Now, back to the story...

Flashback: Recovery

OK, that's not fair, this isn't really about recovery...I don't remember that. My first cogent memory is being wheeled into my room and, as I come around the corner, seeing Lucia waiting for me. I reached out and croaked, "Svenska!" Croaked because that's all I could do after having the tube down my throat during surgery...ouch.

The nurses were on hand to begin my education. I looked at the catheter...WHOA...I expected a small tube the size of a cocktail swizzle stick...instead, there's a damn garden hose coming out of my body. Doesn't hurt, but unexpected. There's also a small tennis ball sized bulb coming out of my left side that needs to be emptied every few hours (I'm told later it's a drain).

I'm asked if I want anything for pain and I say, "Sure," a decision I may regret in hindsight. I'm also given stool softeners (sorry, but this is a full report), and hooked up to other equipment.

Lunch is delivered and while I'm not really feeling like eating, I dive into the Italian Ice to soothe my throat. I eat some of the salad, and some crackers and yogurt...then it's nap time.

Later in the afternoon I'm helped out of bed and take a short walk with Lucia.

One piece of equipment keeps signalling a problem, and I'm told I have sleep apnea, "No I don't," I respond. My oxygen levels, as a runner, are always great. But the nurses keep telling me to take deep breaths when the alarm sounds...sometimes it works, sometimes it doesn't, and they are surprised when the levels jump from 70% to 98-99% in an instant. I continue to insist the sensor is defective. More on this later.

Lucia is given a lesson in cleaning the catheter, and I becoming very casual sharing my groin with multiple women...all of whom, with one exception, are strangers.

Coughing brings a new level of awareness to the ports in my body, and then I develop hiccoughs. God, I hated those hiccoughs!

More to come, but first the upcoming announcement...stay tuned.

Flashback: 2 hours to surgery

We arrived at the hospital at 5:20am and handed the keys to the valet. As we walked toward the door I realized this was the last two hours of having a "free range prostate," but remained calm.

The checkin procedure was quick and efficient, providing a tracking number for Lucia to track my progress throughout the morning, giving her a pager (like a restaurant), and suggesting there is coffee ready at all times. I watch a gentleman register who has no one to wait for him...and I feel sad for him. I listen as people talk about their impending surgeries...some, obviously, having procedures similar to mine.

Soon a nice nurse calls my name and walks us to the elevator to go to Pre-Op. In Pre-Op, she provides a gown for me and introduces us to the nurse who will take care of me until time to head to surgery.

Vitals taken, IV started, advice for what I might experience upon awakening and how to respond.

The surgeon stops by and says hello asking if I have questions (too late). Then the gas passer stops by and asks if I have ever had anesthesia before...I thought I had with a colonoscopy, but he said that was just the light stuff. Then he asks if I might want something for anxiety before I head to surgery. I accepted like I was back in college in the 60s.


Then they come for me...I kiss Lucia goodbye and make the trip to the operating room where there is all kinds of activity. I'm still surprised how calm I have remained...perhaps a reflection of the confidence I have in the team I have chosen (critical regardless of the treatment you choose). The robot is being assembled and looks impressive, the surgeon again says good morning, and that's all I remember before awakening.

Flashback: 15 Hours to surgery

We arrived at the hotel near the hospital and hauled our considerable supplies upstairs. The room was comfortable with a great view of the river.

As my "prep" didn't begin for an hour or so, we drove over to the hospital to locate the entrance, then stopped for some coffee at a restaurant.

At 5:00pm, I began drinking what would be three liters of liquid laxative in three hours. Having never had this particular routine before, I asked a friend, and remarkable nurse, Peg Lougman ( henceforward to be known as Peg the Wonder Nurse), how to get through the volume of nasty stuff.

If you learn nothing else from my experience, this will help if you are faced with a similar requirement. Peg told me to suck on a fresh lemon before and after each 8 ounce dose until complete. It works! I had no difficulty whatsoever. Oh yeah, and keep the liquid as cold as possible.

The next several hours were spent waiting for the liquid to do its work...then waiting for it to complete its work.

We awakened around 3:45am to shower and prepare for our 5:15am departure for the hospital. I was surprisingly relaxed...empty, but relaxed. Anxious...a bit. Ready to get this behind me...without question.

Next up....checking in and pre-op.

Home Sweet Home

It's true...there's no place like home. Arrived yesterday afternoon and had turkey and mashed potatoes to celebrate the best Thanksgiving day I can recall.

Oh yeah...took a shower...here's the thing, the hospital is not a place where personal hygiene receives much attention...I was disgusting (no comments, please).

The catheter is a bit of a bother, but there is no discomfort or pain. The surgical site is interesting...five surgical ports (the largest of which is about an inch long) and a drain port.

Waiting for an appointment next week to remove the catheter may be the longest (and most bothersome) part of the procedure...to date.

Walked outside this morning and enjoyed the fresh air.

I'll detail the trip to Columbus and surgery day next...if you're in line for treatment, it may help to know what to expect.

Going Home!

Kind of a rough day yesterday, but had a great night and feel really good today. I'll fill in the holes when I can use a real computer...this notebook is tough to use in bed!

Touchdown!

Surgery complete...in my room enjoying (?) jello and tea. More later.

25 Hours before surgery

Well, after the decision was made I got busy...busy learning those blasted kegel exercises, busy reading about catheter care, busy buying all the stuff I might need at home when I return. I was busy too talking with the surgeon's office and the hospital...I have to mention how impressed I have been by how friendly, compassionate, efficient, and professional everyone has been. I end every conversation by saying, "And I'm looking forward to meeting you...you do visit all the patients the morning after the surgery, right?" That idiotic, smart-ass, question is always met with a laugh and a reassuring, "I wouldn't mind it...what I always hear from patients is how good they feel after the procedure."

Another observation I want to write about in length at another time is the number of men I have encountered who have either had treatment for prostate cancer (and they all are very positive about their treatment no matter which was chosen) or have been diagnosed. We are a big fraternity and we need to be more vocal and visible about prostate health.

So, today I awaken to a clear liquid diet followed by the dreaded prep beginning at 5:00pm. We're driving to Columbus this afternoon and checking into a hotel close to the hospital as I have to be there at 5:30am for my 7:40am surgery.

I mentioned I have never had surgery...so there is some anxiety, but the primary cause of the anxiety is not the procedure, but that damn catheter I'll be wearing for a week or so. Never had one of those puppies and I can't imagine what it's going to be like (remember how I practiced the biopsy hurting??? I can't figure out how to practice the catheter thing).

Good friends, great health care professionals, and Lucia have made the journey thus far a good one. OK, it's a trip I would prefer I did not have to take, but it has been a growing experience not devoid of humorous moments as well.

Next time (tomorrow, I hope) I'll post from the hospital after the procedure...stay tuned.

Talk - Think - Decide - Back to step one

It didn't take long to discover Lucia was thinking along the same lines as yours truly, if you know Lucia she doesn't hide her opinion...on anything! She found confidence in the surgeon and his office and so did I. So...actually thinking surgery, I called for an appointment with Dr. Long who had ordered the first blood test.

I said to Dr. Long, "On the day you told me I should schedule a biopsy you said, 'and if it's cancer we'll schedule surgery down in Columbus.' Knowing what you know now...would your advice be the same?"

Well, he started the usual examination of the options and their likely outcomes and I stopped him, "OK, hold it. Here's what I'm thinking and why I'm thinking it...you listen and then tell me what you think of my decision."

When I finished, Dr. Long said, "So you've decided upon surgery...OK, since you've made your decision I'll tell you...that's what I'd do if I were in your place."

Then we laughed about many of the experiences I have had, shook hands, and I walked out ready to call to schedule the surgery. Deal done.

There is a calming effect of making a decision...and I felt better than I had in weeks. Lucia noticed my improved attitude and we began to plan the "grand opening" together.

Dentist, Lawyer, Artist, Friend

Now I'm ready to talk about Ken...I first met Ken when I was sent to him for a root canal. Recently retired, Ken's prostate cancer story is far different than mine...but I sought his council as I greatly respect his intellect (although I question his judgement with regard to career choices...why not just get a sign that says "asshole" and wear it around your neck? It's a sign that's been suggested for me for any number of reasons far more personal than career choice! Here's my sign.).

Ken had a PSA of 2 and a tumor the size of a tennis ball undetected until a routine DRE (the fact it was on, and not in, his prostate was the reason for the low score...I think). Anyway, his surgery was lengthy and there were later complications that resulted in an atypical experience...but he has rebounded to become a fierce advocate for men talking about prostate health and having regular DRE's.

A well known author on a variety of topics relating to dentistry, Ken has recently been writing and speaking on matters prostate.

We met for lunch and Ken talked at length about the various treatment options currently available. He also invited me to join him for a regular support group he attends in Columbus. In fact, he had made inquiries of his support group regarding the surgeon I saw for my second opinion and had very positive responses.

Ken shared websites for me to visit for more information, and again urged me to include Lucia at every step along the way...the support group has a group of significant others as well.

Best of all, we laughed a lot about the process, the procedures and the Pampers...excuse me, Depends (had that alliteration thing going there).

The more time I spend thinking about the options, the more surprised I am at the attraction for surgery I'm feeling. Here's my reasoning: for me, and that's important as my decision will only be right for me and should not be considered definitive for anyone else, surgery, which I considered the most radical option, now seems to be the most conservative.

In the event of future problems, my research leads me to believe of the choices in this area at this time surgery provides the most options for treatment; it also offers the best opportunity for nerve sparing when performed by an experienced hand. I've found the man and settled on a course of action. I'm going to talk with Lucia and, if she agrees, it's back to my family doctor to discuss my decision.

Wow...I did not see this coming.

Second Opinion

Wait a second, before I met with Ken, I had my second opinion visit...I was reminded of the timing as I began writing about Ken who was the one who made me promise to take Lucia with me for the consult.

I traveled to Columbus Riverside Hospital to meet with Dr. Burgers (like mergers...anyone watch "Keeping Up Appearances" on PBS?), Norbert's Urologist. As I walked into the office I noted the sign on the door included the word "Surgeons" and, knowing how everything looks like a nail to a man with a hammer, knew what I was going to hear.

Dr, Burgers is an amazing man...his training and experience speak volumes. He explained the advantages of robotic surgery and typical outcomes. Within about ten minutes of the visit he told me to go down the hall to speak with Shirley and schedule my surgery...I stopped him right there, "Whoa...I'm here for a second opinion...I have not decided upon a treatment yet." We then continued the conversation regarding all of the options, but agreeing that my case did indicate intervention. Lucia asked much better questions than I (women are better at that than men) which may be why Ken insisted I take her along.

Then a rubber glove magically appeared, Dr. Burgers asked Lucia to step out of the room, and became the most recent stranger to put his finger where I'd rather it not be.

We did meet with Shirley who provided very helpful information and a list of potential dates if I should decide upon surgery. This office is a well oiled machine, and I mean that as a very high compliment.

We had dinner and a bottle of wine at a restaurant on the way home and talked about what we had learned. Lucia was very impressed with Dr. Burgers (he's an impressive guy), and gave her usual reasoned opinion. I began to consider surgery for the first time as a possible option.

Then I called Ken, told him what I had been doing and we met for lunch (he said he'd buy...but that's not gonna happen).

Kevin

Kevin is a valued client and one of the sharpest advertising minds I know...if it's "out of the box" and successful, it was probably Kevin's idea. If you need ideas, contact Kevin@KGGroupMarketing.com (you won't be sorry).

As I mentioned earlier, Kevin and I were diagnosed very close in time and our numbers were almost identical. When I called Kevin to catch up with his progress, he impressed me with the research he had already completed and surprised me with his resolute decision.

Kevin had opted for a surgical approach to his prostate cancer. "Why surgery?" I asked, because that was way, way, way down on my intitial list. Kevin's rational was reasoned, logical, and eye opening for me. Suddenly, considering surgery was elevated in my decision matrix by virtue of our conversation.

We spent the next several minutes discussing our mutual journeys, the people we've met, and our desire to further the cause of making men aware of need for early and regular check-ups.

Our conversation concluded with a pledge to stay in touch through the process and to stay strong in both our personal faith and our faith in the future (not sure you can separate those now that I look at them). I really like Kevin but even when I hung up I was still not sure I could fully understand his eager embrace of surgery.

Then I made a lunch date with Ken, my dentist-lawyer friend who has had a completely different experience with prostate cancer.

Norbert

Norbert was the first person I called after being diagnosed. As I mentioned in an earlier post, Norbert's been battling prostate cancer for nearly 15 years having endured almost every treatment available while maintaining a positive attitude, faith, and his running career.

As soon as I contacted Norbert, he recommended I make an appointment for a second opinion with the doctor he has been with since the beginning of his journey. I accepted his suggestion and made the appointment.

Admittedly, there is a great difference between what Norbert has been fighting and my, comparatively, minor case (if there can be a minor case of cancer). None-the-less, I wanted to hear from one of the best, and Norbert's physician has been recognized as such.

Norbert and I met for coffee as well and he shared his story and his opinion of the options with which I was confronted. It was comforting to hear Norbert express confidence I am going to be OK regardless of the treatment I choose...and then he talked about the icky parts of the treatments and beyond...the catheters, incontinence, erectile dysfunction and the like; again, I was assured I would overcome each trial.

I left the meeting feeling a bit better about the future (it may have been just the feeling of taking charge by beginning to actually do something instead of just worrying about it).

The next evening I called Arizona to speak with my friend and client Kevin Nutt, and what he told me really took me by surprise.

What to do first?

Most of us have never had prostate cancer before, and the news can leave one a bit disoriented. The doctor is telling you to do some research and provided a few pieces of information...but you're pretty much on your own. Curse you non-directive, empowered patient, don't ask me to say anything I could be sued for medicine!

I have a number of friends who have experienced the wonderful world of prostate cancer, and I began calling them, asking for a chance to sit down and discuss what was before me.

I also began searching the Internet for information...this proved very frustrating as the outcomes for the various treatment options are very similar for early stage cancer like mine. I also looked at the possible complications/implications post-treatment; and again the options all presented very similar information. So, how does one make a decision (I likened it to being offered a great job and being very excited...until the other four equally appealing offers roll in.)?

I opted for a second opinion and conversations with friends. Interestingly, other survivors presented themselves out of the blue. It was as if the universe was providing information for me.

I began with Norbert Peiker, a friend and mentor who has been battling prostate cancer for nearly 15 years.

Best of the worst

I asked Lucia to come with me to get the results of the biopsy, she's going to be an important part of this whatever the result. As we drive to the office, she's trying to put me at ease, but I've got too much on my mind to listen.

The waiting room was crowded, but we weren't there long. The nurse, the really cute one who liked the way I emptied my bladder, escorts us into a consultation room, takes my temperature, and does the blood pressure thing (not surprisingly it's a bit high).

Then Dr. Peck comes in...he's smiling (that's a good sign...right?). "Well," he begins, "if you've got to get a positive result, this is the best news you can get. Let me read from the pathologist's report: 'A minuscule focus in one core.' (at least, I think that's what he said...I kind of zoned out after hearing the word positive)."

"So," he continued," this is curable (I heard that!), and doesn't mean surgery is required. If you were ten years older, I might suggest we do nothing and just keep an eye on it (Hey Doc, I don't want to be ten years older for at least ten years)...but at your age, I think we need to treat this.

You might want to get a second opinion, I'll be happy to send the file to whomever you wish.

If you decide on radiation, you can choose either open beam or go with the seeds and I'll set you up with a radiologist. You should spend the next few weeks reading about the options before you make your decision (my decision?). We'll set up an appointment before you leave."

I tell him I'm glad surgery is not required as I'm surgery free and would like to remain so. Then I shake his hand and follow him down the hall to get my little booklet about prostate cancer...yep, I've got cancer...and make the next appointment.

As we leave the parking lot, Lucia begins to talk for the first time since we entered the consult room...but I'm not really listening...cancer, I've got cancer.

The procedure (gulp)

Dr. Peck enters the room looking entirely too happy (of course, he's not going to have anyone violating his person) and cheerful. He asks me to lay on my side facing the wall (no witnesses?). I ask if I can continue to read my Kindle and he responds, "If you can, sure."

I feel the procedure begin...which should come as no surprise, it's hard to sneak up someone's rear end with what feels like a garden hose and not be noticed...and I steel myself for the anticipated pain.

There's the stick...and the click. Dr. Peck says, "It doesn't get any worse than that." WHAT? That wasn't nearly the back-bowing pain I expected. In fact, and this is true only in my case and cannot be generalized to anyone else, my first thought was, "I've had dental hygienists hurt me more cleaning my teeth!" It should be noted I have talked with others for whom it was a much different experience.

I actually did continue to read through the procedure and although a few of the cores were a bit more noticeable, overall it was not at all difficult.

"That's it," Dr. Peck said, "we'll clean you up a bit and you'll notice blood in your urine for the next four or five days and in your semen for two or three weeks, but that's normal. If either continues, give me a call." and he's gone.

I tell the nurse, "I think the anticipation is much worse than the experience." and she says she hears that a lot.

Editorial comment: If you are required to have a prostate biopsy, do not fear it.

Then she hands me a pad, shows me how to put it in my underwear, and leaves me to get dressed (I mean she leaves so I can get dressed, not her). Soon I'm walking down the hall to the checkout where I'm told the results should be known in seven to ten days. I make an appointment and I'm out the door where Lucia meets me.

On the ride home I notice I feel a bit odd...not bad, just odd...and I think about eating breakfast. Now the long wait begins.

Here I go

I stand, on somewhat shaky legs, pick up my Kindle, and start toward the door the nurse is holding open (not the same nurse I impressed with my bladder emptying skills on my first visit). Lucia asks if I want her to come with me...HUH? First of all, Lucia is a wonderful person, but she can't watch blood being drawn without fainting; second, I don't think this is going to be pretty. Taking all that into consideration, I say, No," and enter the hallway where the nurse directs me into the procedure room.

"Take off your pants and underwear, you can leave your socks and shirt on ("thanks"), put this sheet on and sit on the table...when I come back, I'll tell you what's going to happen."

Pants & underwear off, sheet on, up on the table, waiting and pretending to read.

"OK," she says as she enters, "I'm going to flood the area with this anesthetic, there is no shot, then...(WAIT! There is no shot? My friend from Arizona said, "Take the shot.")...then the doctor will come in. You'll feel some pressure, then you'll feel a stick and hear a click. At this point it's a mind game; what you want to do is say to yourself, 'that's one, seven more to go,' and count down to get through it."

I ask, "Will I be able to read my Kindle during the procedure?" but what I am thinking is, "Holy crap! Mind game? Get through it? Mommy!" Then she floods the area and we both wait for the doctor to enter the room.

The biopsy

Does anyone enjoy preparing for lower GI type tests? Given the serious nature of the procedure, I was generally surprised by the simple prescription for either two laxatives the night before, or an enema 2 hrs. prior to the biopsy...and being one of those, "If a little bit is good, a whole lot is better," guys, I decided to do both.

The laxative portion was gentle and did not interrupt my rest...much. The enema was, well, you know.

Soon I was in the car, Lucia behind the wheel, and on the way acting like I was just going to an appointment like any other.

We arrived at the office, walked into the waiting room, located seats near the door, and I opened my Kindle and began reading as I waited. Then the Nurse called my name...

I'm not proud of this...

As a result of the comments I was hearing about the biopsy, I let my mind travel forward in time to the experience...and I didn't like what I was seeing (and feeling).

Knowing Lucia was in the waiting room during my procedure, along with a collection of other patients, I didn't want her to hear me making "ouchy" noises (or whimpering, or any of that stuff). So I practiced!

True story; I stood in front of the bathroom mirror and practiced stifling sounds of pain. I sought the best combination of facial grimaces and guttural vocalizations that expressed pain without volume. Soon I became proficient in an art I had not previously known existed...in fact, I may have invented the genre.

I'm not proud of this...but it's true and if anyone reading this is facing their first biopsy, stay tuned...if you've had a biopsy and want to share your experience, feel free to chime in at any time. As I said, we need to talk about this stuff.

Next up...the biopsy.

Waiting

So, while I'm waiting for the date of my biopsy to arrive, I try to gather as much information as possible about what I'm facing. This was a mistake! I read two or three books (more properly, sections of two or three books) that described the procedure and likened it to snapping a rubber band on your wrist...except it ain't rubber and it sure as hell isn't my wrist. I also contacted friends whom I knew had been through the procedure.

First was Ken. Ken is a dentist who decided being a dentist was bad enough...so he also became an attorney (so no one talks to him at cocktail parties). Ken has become a strong advocate for men's prostate health and immediately sent me a few articles he had written on the subject for a publication. Within the first three sentences I found the words, "It HURTS (his emphasis, not mine)," well, now I'm feeling better...not.

It was during this time I learned a client, and valued friend, in Phoenix had been mirroring my experience and had just had his biopsy. His advice, "Take the shot."

Another friend mentioned the rubber band analogy, but added, when I mentioned the shot remark, that I'll probably want to drink several shots both before and after.

I had decided Lucia needed to be a part of the whole adventure (she had expressed her wish to do so at the first mention of trouble) so I asked her to accompany me the day of the biopsy and drive...even though I had been told I'd be OK. Lucia quickly agreed.

Now it was just a case of wait and continue reading and talking...and thinking.

Bill's first Urologist

I have no idea what to expect on my first visit to the Urologist...but I'm pretty sure he's going to do that digital thing, UGH.

I arrive a bit early because I'm sure there's going to be the usual collection of paperwork to fill-out. The lady behind the window seems very nice and she does indeed hand me a stack of papers. I quickly complete that task, then sit back a wait for the call trying very hard not to make eye contact with anyone else in the waiting room.

"William," the nurse (I think) calls, "follow me." Here we go. As we enter the room she asks me to take a seat, takes my blood pressure (elevated...to be expected) and hands me a small cup. "I want you to fill this in the restroom across the hall and then empty your bladder as much as possible." It was at this point I recognized how really cute this young lady is...and she's asking me to empty my bladder, something no woman has ever asked of me before!

I comply with the request and return to the exam room where she tells me to take off my shirt and loosen my pants as she's going to do an ultrasound of my bladder to see how much I was able to empty.

"Less than one ounce! My, you certainly do empty your bladder well," the cute nurse tells me...again, something no other woman has ever said to me. Come to think of it, no man has ever said that to me either. "The doctor will be in shortly," and she walked out of my life.

Soon, the doctor enters and I like him immediately. He's young-ish, and has a friendly manner. After a few questions, it's drop trou and here comes the digit! Then he tells me he's going to schedule the biopsy. "It takes about fifteen minutes here in the office and you'll be able to drive yourself to and from the appointment if you wish." Then we're on our way to the front desk for the appointment and some literature about prostates, biopsy and how to prep for the biopsy (JOY!).

"You can take two laxatives the night before, or an enema two hours before the biopsy," she tells me.

Then it's over and I'm on my way to work...and ready to ask everyone I know who has been through the procedure about a biopsy...what's involved, does it hurt?

The "C" word surfaces

The doctor comes bounding into the room in his usual way and sits down. He then proceeds to tell me the blood work came back and everything looks great with the exception of my PSA. OK, heard it before Doc, just get to the, "We're going to monitor it every six months for the next year," part.

"Your PSA has climbed to 5.6, so I'm referring you for a prostate biopsy (gulp) and if it's cancer, we'll just send you to Columbus for robotic surgery and take care of it. Take this out to the girl at the desk and she'll schedule an appointment with the Urologist. Any questions?"

Ummmmm...yeah, about a thousand beginning with, "WHAT? What the hell happened to monitoring? Is this thing gonna hurt? What do you mean cancer? Is this thing gonna hurt? Can I still drink? And, is this thing gonna hurt" but what I say is, "Nope!"

I hand the paper to the lady at the desk, she calls the Urologist and schedules an appointment for me on August 24 with Dr. Peck (no jokes please). Then I get in my car, call Lucia and tell her I've been referred for a biopsy (horrible word, biopsy). Then I go back to work, but all I can think about is what might be in front of me (or in the case of the biopsy, as I understand it...behind me). The two weeks before the appointment are filled with all manner of thoughts, sleepless hours, and remaining falsely brave to the world.

I contact friends I know have been through the whole prostate cancer thing and they begin my education. I've got a lot to learn and absolutely no desire to do so. And now...Here's Dr. Peck!

My prostate's adventure begins...

About two months ago, I arrived home and saw the message light on the answering machine blinking. Pushing the button, I heard the doctor's office reporting my routine physical blood work had come back and the doctor wanted to see me due to an "abnormal" PSA. No big deal, I've been through this before...an elevated PSA is something I've lived with for a few years; we're watching it, but no alarm.

With a PSA above 4, we began watching the readings to get some sense of the rate of increase. It did climb, but at a rate the doctor felt comfortable with for a patient my age (I was probably 57, or so, when we began monitoring). I knew what we were going to talk about, so I felt comfortable waiting.

And thus began my adventure leading to surgery less than three weeks from today. Prostate cancer is something men don't talk about enough...women talk about breast cancer all the time (OK, OK...I know, "Boobs are a lot more fun than prostates." but that's not the point.). We need to talk more about this, so I'm going to chronical my journey...it's been interesting, scary, funny (yes, funny), and very eye-opening.

So climb onboard and follow me; heck, I don't even know where we're going in the future...but you're invited to come along. And I encourage you to talk back to me, tell me your story, offer advice, whatever...but let's talk!