Under the Knife

In early October, I went in for my annual physical. A task rarely undertaken annually. With all of the happenings of 2012, the plan was to clear the decks and step back into the daily routine with a clean slate. Health seemed like a good place to start. Why I didn't procrastinate as I normally do is unknown, but in this case it proved fortuitous.

An appointment was scheduled with my Dr. Brad, a physician and healer that I have known for nearly 30 years. It's great when your family doctor lives only across the alley; great for us, maybe not so much for him and wife Michele. He has generously made more than the fair share of house calls and alley health consultations. He is a kind soul and an age contemporary. I've considered it a measure of our friendship that we can continue a joke or conversation during a digital rectal exam.

This year's DRE was uneventful although the PSA blood test did come back at 4.4. For a fellow my age, less than 3 is desired. Plus it had increased from the previous year's 2.8.  PSA, or prostate specific antigen is a measure of a protein in the blood. Elevated levels indicate potentially ominous activity in the prostate, perhaps cancer. We talked about monitoring it for another 6 months. Given my emotional sensitivities to the subject of cancer, I chose to pursue prompt further evaluation with a urologist.

On October 29th, coincidentally what would have been my 36th wedding anniversary, I met with urologist Chris Knoedler, MD. I mention my anniversary only to acknowledge how much interest JoAnne would have had in watching me enter into health related issues, examinations and treatment of my boy parts. After all the indignity and immodesty she endured through child birth and her cancer, she would occasionally mention with a sinister chuckle how my day would come. 

Dr. Knoedler and I began our relationship with polite conversation, a review of health history and the digital rectal exam. It's almost like a handshake for these guys. My prostate was not enlarged, nor were there any ridges or surface irregularities. Given that, he recommended a biopsy to verify the presence or absence of cancer. 

Here is where I needed to give thought to how or if I should blog about this rather personal experience. I'm sure my kids are already queasy over the image of Dad bent over the table during a DRE. Then there are those women who have been wronged somewhere along the journey by the male gender and don't mind seeing any male suffer insults to his pride, masculinity and boy parts :-) I'll take one for the team, guys. And we can still be friends, ladies.

Having one's prostate surgically removed carries with it the risk of two sensitive side effects; incontinence and impotence among other typical surgical risks. People don't like to talk about such topics. Especially men people. And yet, prostate cancer incidence is significant and is likely to occur in virtually all men if they live long enough. There is also controversy over the proper testing, monitoring and treatment of it. Many grow so slowly that men will die with but not of prostate cancer. Age plays into the equation. When I met with Dr. Knoedler, he summarized a half dozen treatment options. My immediate reaction was that if there were that many, none of them had proven to be the silver bullet. There were pluses and minuses to each option.

It is a challenging decision and among others, I relied on friends who had undergone the procedure for insight and information. Now with some personal experience and the ability to write, it strikes me as a topic worth discussing. There are medical, emotional, physical and relational issues involved. It is one of those fork in the road experiences on the life journey.

In the end (see what I did there?) I did choose robotic assisted minimally invasive radical prostatectomy  surgery. That was performed on the morning of Wednesday, January 16th. Hospital arrival was 5:30 AM with a 2 hour general anesthesia surgery at 7:15. I was in my room by noon, up walking by 5 and out the next day by noon. And a radical prostatectomy is considered challenging surgery. It is now Friday evening. I'm up and around with a garden hose up my schwanz that is connected to a urine collection bag. The pain from 6 small keyhole incisions in my belly is manageable. My throat is sore from the breathing tube. They had difficulty placing it due to my anatomy and had to apply some elbow grease. I can feel it.

It's almost time for some Percocet. In the hospital, my pain was managed so well, that I didn't realize there was any. When I got home, I violated my cardinal rule: When offered pain killers, always take them. Don't try and tough it out. I tried and failed. The belly is sore. I am going to take some and sign off for the night. I'll back track over the next week or so and tell the rest of my story.   

In reading a book written by a doctor about his prostatectomy experience, he was challenged by how to refer to the male anatomy. Penis sounds so clinical. I agree with him on that part. I'll go with schwanz; w pronounced as a v and shortened from the movie Young Frankenstein, one of my all time favorites. Or maybe Winky ;-)

Thanks to all who have sent along thoughts and prayers. You are my best!

And the Beast Goes On