Posts Tagged 'PSA'

Slide your fanny a little…

“Slide your fanny a little bit back from the edge.  A little more.  Until it touches my hand.  That’s it.  You got it.”

Risque?  Hardly.  Warm and fuzzy?  No.  It was only Nurse Ratched getting me in position for my long anticipated prostate biopsy.  Sexual innuendos and any semblance of privacy were the farthest things from my mind.

For those of you who have faithfully followed my blog, you may recall a piece I wrote about a year ago that displayed in living color the unrelenting progress of my PSA readings.  Readings that, in some corners of the medical establishment, leave the suspicion of a sinister, cancerous infestation of my prostate gland.

I had dutifully made several breath-holding follow-up visits to Dr. Goldberg my busy, generally humorless, urologist.  This series of perilous events  led to the last one, an all too brief encounter a month ago where he blandly announced “Your PSA is up again.  Time to find out what’s really going on in there.  It’s fifty-fifty on the outcome.”   Huh? I thought.  That’s it?  No preliminaries, no show-and-tell.  Not even a hand on the shoulder.  “Just make a biopsy appointment for a couple of weeks from now and bring your body back here.”

During those weeks I had ample opportunity to think about the worst and to explore in-depth the components of the dreaded procedure.  However, except for a couple of brief light-hearted discussions with friends, I disdained the bountiful educational opportunities offered by the web, the local library and the Jewish Forward.  The most memorable and illuminating conversation was the one had with Harry.  “I spoke to a friend of mine.  He had a prostate biopsy.  No big deal.”  My, how reassuring.

The big day arrived.  I prepared and cleansed my body as instructed.  I swallowed the rather large antibiotic pill taken as a precaution against a possible infection that I was convinced was surely as deadly as 18th century bubonic plague.

Sweetie and I arrived at Dr. Goldberg’s office, early as usual.  I embarked on the obligatory viewing of the same travel magazines seen during my earlier visits and, realizing that I had absolutely no idea of what I was reading, settled back while the clock wound past my appointed time.

Other than the need to argue with the bookkeeper about co-pays, I passed the time wondering what particular urinary malady was afflicting each of the other sullen faced men sharing the waiting room with me.  The Halloween decorations, especially the sheeted ghost hanging by its neck over the entry door, did little to lift one’s spirits.

Nurse Ratched appeared and escorted me to the operating chamber.  I was a bit disappointed, given the singular importance of the upcoming procedure, that it did not look more like Mel Brooks’ laboratory in Young Frankenstein.  Nurse Ratched took my blood pressure, pulse and temperature.  All were functioning…a good sign I thought.  I was then instructed in the proper removal of clothing and the donning of that never to stay in place paper cover-up.  I was left sitting backless and alone on the dissection table.  “Back in a few seconds” Nurse Ratched promised.

Time passed.  Anticipating that I might somehow be forgotten and left to starve to death, I reviewed the contents of the chamber.  The most imposing element was an ultrasound machine.  This clever device is used by the physician to locate, measure and help zero in on the parts of the prostate gland that have been chosen by lottery as the lucky ones for biopsy.

Once located, a small snippet of obviously useless living matter is clipped, removed from the dark recesses of one’s body and deposited in a carefully (I hoped) marked container to be sent off to that mysterious place that none of us has ever visited, called the lab. There it sits ignored for what seems like an eternity while god only knows what is done to it to determine whether it is, in that generic inoffensive terminology, negative or positive.

The scariest piece of the ultrasound machine is the probe that will, when the smiling doctor appears, be shoved ingloriously into your anus on its way to the blessed area occupied by that one ounce piece of meat called your prostate gland.  With time on my hands, I had ample opportunity to observe the impossible size of the probe and I wondered what it might be like to be incarcerated in prison with giant men who have been deprived of female company.  Not a pretty sight.

And for more laughs, I stared at the near life-sized chart on the wall depicting a fully functioning urinary system including a monstrous penis that put me to shame.

Having waited for what seemed like hours, I was preparing to remove my useless paper cover-up, get dressed and sneak from the office when Dr. Goldberg arrived.   Nurse Ratched, careful to make no clever comments about my private parts, began the arduous job of sliding and positioning my fanny.  She then  placed my feet into the same kind of stirrups that you women are more likely to encounter as you pass through life.  I really don’t know how you manage it.

“We’re going to take ten snippets” Dr. Goldberg announced.  “The hardest part is getting this probe past your great wall of China.  After that it’s a walk in the park.”

Around snip number three, and concerned that I might be left prostate free, I asked how much the ten snippets weighed.  “Everyone asks that” Dr. Goldberg laughingly said.  “Your prostate weighs about twenty-eight grams and the snippets will total less than a gram.”  Seemed hardly worth the effort, I thought.

Snippet ten occurred at about the five-minute mark.  Or, in Fred time, about twelve hours.  Done, we all breathed a well-earned sigh of relief.  I was allowed to recover some of my dignity, get dressed and proceed to the waiting room of sullen men where I gave Sweetie a big kiss.  I’m due back in Dr. Goldberg’s office in about a week.

Meanwhile Harry, tell your friend that he must have practiced.

Is it prostate or prostrate?

It’s the simple things that count.

Our day started with a trip to Dr. Ericson’s office for Sweetie’s every three weeks’ allergy shots. A ritual that has gone on since well before the foundering of the Titanic, the serum allows us to luxuriate in the Upper Ojai where, other than during a nuclear holocaust, something is always discharging its microscopic sexual reproductive organs into the air. Pleasantries exchanged, Nurse Ratched smilingly deposited the magical serum into both of Sweetie’s arms. Better two than one, I always say.

Following the insinuation of the sinus clearing, sneeze modifying and itch suppression miracle drugs, we proceeded across the road to the ever friendly confines of Ojai Community Hospital. Other than the classy emergency room which is usually entertaining a near-relative of Evel Knievel who misguidedly believed he could defy the laws of gravity, the hospital normally seems quite peaceful and generally deserted. As though it were really a front for something else, like a pot farm, it graciously absorbs our periodic donations, generated to some degree by our fear of the hospital’s potential demise. Thereby condemning us to the big city where we will be absorbed in the less homey environs of the ever-expanding Community Memorial Hospital.

It was my turn in the barrel. My last physical revealed the continued, fear inducing, and generally misunderstood elevation of my prostate specific antigen. Better known as PSA, I have been following my own numbers with mild interest for several years and have, with an occasional slip, finally learned the difference between prostate and prostrate.

My two-year ago physical, ably performed by Dr. Ericson, prompted my first visit to the friendly Dr. Goldberg, a jovial, middle-aged urologist, conveniently located near Trader Joes. Dr. Goldberg’s probing and diagnosis resulted in his sage country doctor advice to “go home and let me know if anything happens”…whatever that meant.

Nothing happened…until two months ago when my PSA crossed a new, exciting threshold prompting Dr. Ericson to say, “let’s try that test again in February, maybe this one was a fluke…oh, and avoid sex within five minutes of the test as it has been known to raise PSA levels.” Although mildly constraining, I accepted his reassuring technical advice. Hence, my return to the hospital lab department where, after a search for a suitable vein, I proceeded to donate several liters of PSA laden blood.

Unfortunately, the results of the make-up PSA test mirrored the previous one. I had again flunked the test with a D-. Time for me to listen up and pay attention. Especially since Dr. Ericson had previously regaled me with a plethora of mind-numbing tales about the misguided folks who had, in the words of that ancient grail knight in one of the Indiana Jones movies, chosen poorly. Not me. I’m going to spend another glorious afternoon with Dr. Goldberg.

The debate over the need for and value of the PSA test continues to rage. Googling will provide you with a boxcar of information that is both informative and argumentative, not to speak of the impact it has on your systolics and diastolics. Friends are likely (other than women friends) to either have personally been confronted by rising PSAs or will have a relatively uninformed, but kindly opinion of what one should do about it. Ranging from nothing, to better make sure your will is up to date. Easy for them to say.

Cousin Ronnie was particularly helpful by sharing his own story, that of our three prostate challenged uncles and, finally, the alternate universes experienced by a gaggle of his business colleagues, some of whom had, as we say, chosen poorly. Bless his heart. He means well.

So, it turns out that March will be my “let’s explore new vistas” month. In addition to the probing sure to be employed by the jovial Dr. Goldberg, it’s also the ten-year anniversary of my last colonoscopy. It’s an event scheduled to nearly coincide with Dr. Goldberg’s hide and seek party. Alas, it’s too bad the plumber and the gas man can’t buddy up and lead but one expedition into the dark recesses of my anatomy.

And keep things simple.



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