FOR SALE:
Fireplace insert.  CHEAP!  Had prostate removed, can't get wood anymore.

    If you remember a short time ago I told you that October was, undoubtedly, the worst month of my life.  Among other things I had found out that I had prostate cancer and it was a rather aggressive little beast that suddenly demanded all of my attention.  Like most people would, I started researching as much as possible about prostate cancer to better understand what I had come to find out about my case.  It wasn't pretty.
    My PSA (prostate specific antigen) was 6.8, which is not out of the ball park by any means.  The desired score is between 0 and 4 and I had never ventured out of that arena in the past seven or so years I had been having it measured.  The thing that was never discussed was PSA "velocity" or how fast the PSA level rises over a period of time.  I had made mention of a recent jump in the score to my primary care physician, but at that time it was still under 4 so I guess we paid little attention to it.
    Anyway, in October it was 6.8, the alarm was sounded, battened down the hatches, a torpedo was fired up the ol' poop chute and a biopsy taken of the foul organ.  Needless to say, it would be hard to find something good under those particular conditions and this was certainly not the case for me.  The pathology report came back and not only did it indicate a malignant tumor, it proudly gave it a Gleason score of 8.  I have always been lucky in my ability to do well on tests, but this time it seemed to backfire.  Gleason scores run from 2, indicating a very slow growing cancer to a 10 being a fast growing highly aggressive cancer.  With this news, I was immediately informed that a full body Bone Scan and a Cat Scan of my lymph nodes in the pelvic area would be a prudent maneuver to determine if the disease had metastasized.  I suddenly realized that a good rule of thumb is to avoid using your own name and the word "metastasize" in the same sentence.  When you do, it triggers your gag reflex.
    I had both scans scheduled for the same day.  First the bone scan required me to report at 7:30 a.m. and get a radioactive injection.  After that I had a couple of hours or so before they would do the scan so, since I was atomically charged, I went back to the office and sat in the chairs of coworkers that I felt shouldn't reproduce, using my radioactivity for the betterment of mankind.
    At about 11:00 a.m. I returned to the diagnostic center and had the bone scan done.  During this process I prayed as hard as you can possibly pray and still lie flat.  When it was over, I asked the tech that ran the tests if we could look at it and he happily agreed.  I explained that I had just recently gotten my radiology degree through Google Images on the Internet so I was pretty sure I knew what I was looking for.  He pulled the scan up and announced, "They look clean as a whistle to me!"  I concurred with his reading and then asked if I could have a hug, which he declined.  We parted with only a handshake.  As I walked out to the car in the pouring rain I called my wife and told her the news and that it was looking like a beautiful day.  Her entire life has been spent in the medical field so she knew what I was saying was preliminary at best.  I immediately left the diagnostic center and went to the urologist's office for the cat scan.
    The cat scan was about the same, except they did one series of pelvic scans without contrast media and then one with contrast media.  I did both series of scans with prayer.  After it was over I told the young lady that did the scans that my Dr. had said that he would look at them with me if he was here, so she paged him.  Alas, he didn't answer the page.  I wasn't as practiced at the cat scan as I was the bone scan, but I told her that I would like to look at it if I could.  She happily agreed.  We pulled the scans up on the monitor, went through them and discovered a kidney stone but no cancer.  Of course it would have needed to have "CANCER" written across it for me to recognize it on these scans, but I broke it down to looking for bright white spots in places I could identify.  I felt pretty good, but not as good as I did about the bone scan.  Anyway, I thanked the young lady and started out the door.
    Just as I opened the door, there stood my Dr. who asked, "Did you just do your CT?"  To which I nodded yes and he motioned me toward him and said, "Well, let's go take a look, then!"  We went to the X-Ray office and he pulled them up on the computer.  As we started going through them, he quickly saw the kidney stone.  "You have a kidney stone!  Look at that!  WOW!  What luck."  Obviously he was impressed.  I told him that I had been having a pain in my right side but with the cancer business and all I was a little apprehensive to say anything.  He scrolled the pictured back and forth over the kidney stone a dozen times, checked to make sure it was my film, measured it, etc.  "Look at that!  If we hadn't done this, we wouldn't have known about this thing.  Can you believe it?"  As he was scrolling back and forth by the stone he went by another bright white spot and I asked, "What is that?"  He replied, "Oh, that just hardening of the arteries.  But that, " he said deftly flipping back to the first white blip, "is a kidney stone!"  It was obvious to me that this man is definitely a true-blooded, dyed-in-the-wool urologist from the word go.  Cardiology, gastroenterology, neurology, pfffft, forget that stuff.  If you don't pee through it, it can't be all that important.
    "We've got to get that kidney stone out before we do anything else!" he declared.  I sat there for a second and remembered the real reason for being there in the first place.  "Everything else looks okay?" I asked.  "Oh, yes.  I'm not a radiologist, but I don't see problems on the lymph nodes.  Everything looks clear...except that kidney stone."  We discussed how we would get rid of the kidney stone and how soon we would do it.  He offered two ways to get rid of a kidney stone.  Well, actually three.  1.) Ultrasonic lithothripsy, 2.) Laser or 3.) pee it out while squealing like a schoolgirl.  I chose not to pee it out.
    I apparently chose the ultrasonic lithothripsy.  About five days later after I thought I chose the laser method,  while lying on the gurney getting ready for the procedure I realized that the equipment was all wrong for the laser job.  Anyway, I had to get the kidney stone out of the way before I could get the cancer out so I wasn't about the throw up a red flag.  I just took a couple of deep breaths and the next thing I knew I was waking up in post-op.  The results were a bruise on my back and kidney stone sand to be urinated through a strainer for the next couple of weeks.  Oh, and also a lot of bloody urine for a period of time that seemed longer than reasonable to me, but hey what do I know.  As it turned out I had several large pieces of stone that were persistently irritating to my ureter.  When they finally came out I turned them over to the doctor.  I think his nurse is making a necklace out of them or something.  My kidney stones had a slight resemblance to what I imagine a petrified booger would look like.  All told, they are probably more expensive than diamonds.
    My next hurdle was to decide on the type of surgery I wanted for removal of the prostate.  The choices were Open and Robotic.  I researched each as best I could and watched videos of each type surgery.  Truthfully when it came down to it, I decided based on trusting my doctor and the fact that I wanted the surgeons to get every lymph node possible for diagnostic purposes.  You've got lot's of lymph nodes and I was willing to sacrifice as many as necessary to know the cancer hadn't spread to the lymphatic system.  In my mind, the open method seemed to allow the easiest access to the most area that could be affected.  I knew that I would be out of service longer with the open method, but this seemed to be a fair trade for more information.  I discussed the nerve sparing part of the surgery, but the doctor pointed out that was down the priority list a little ways.  There are two nerve bundles on the prostate that allow you to have an erection.  Sparing those nerves was definitely on the wish list, but in reality an erection won't do you any good if you're dead.  This is the same for both methods.
    The Robotic method looked wonderful.  The idea of being back on your feet in three or four days seemed pretty attractive as well.  However it still seemed possible, granted not likely, but possible that something might happen during the procedure and they would have to resort to the Open method anyway.  Another thing that I considered was that the method was only about five years old.  I have absolutely nothing against technology, but I didn't want to risk removing an aggressive cancer when the data doesn't support that it's a "better" method for the job.  Taking the longer recovery time out of the picture, it seemed my experienced doctor performing an open procedure would provide me with a successful surgery AND peace of mind that everything was seen and removed.  If my Gleason score had been a 6, I might have gone with the robotic and never had a second thought.  Actually, that's not true.  I would still think twice because during the videos that I watched it seemed to me that the prostate surgery was somewhat like gutting a fish.  I've gutted hundreds of fish in my day, but I'd have a hell of a time doing it by video camera and robot.  I can picture "GAME OVER" flashing across the screen and hear "Because you had a bad day, you're taking one down..." playing in the background while the 25 year old doctor throws a temper tantrum because he has the wrong game controller.
    The next step was the hospital pre-admission process.  I had to go to an office and interview with a couple of nurses, provide a urine specimen and some blood.  The first nurse asked me about the medications I was currently prescribed and why I was taking them.  I went over everything and then, stupidly, volunteered that I had self prescribed amoxicillin for a sinus infection.  "Are you a Doctor?" was her reply to which I answered, "No, but I am incredibly smart."  Then she gave me a lecture.  When I told her that I knew she would do exactly the same thing if she were in my situation, she said she wouldn't.  We finished up and she passed me on to the next nurse.  It wasn't two minutes before she asked, "What are you taking the amoxicillin for?"  I closed my eyes and said, "I KNEW I shouldn't have said anything.  Okay, I had some at home and I wanted to clear up my sinus infection some before I spent a few days laying flat of my back getting a migraine headache because of sinus problems.  I also didn't want to NOT have cancer surgery because the anesthesiologist thought my sinus' were too bad."  We got past that and finally finished up with the interview.  In the end she asked if I had enough to take a full round of antibiotics, to which I said yes.  With that I finished up by moving on to the phlebotomist.  As I sat in the hallway waiting my turn, one of the nurses asked if I had provided a urine specimen yet.  I asked her if this was some kind of cruel joke because I was having prostate surgery for Pete's sake.  Everybody wants you to pee in a cup when you can't.  So within a minute one of the nurses comes back with a cup of water for me to drink.  I'm telling you these people have a sick sense of humor.
    After a few more minutes I went into the phlebotomist's room and provided her with blood for a small collection of vials she had.  We chit-chatted for a few minutes and she told me when I gave the urine specimen I could go.  I went to the rest room and unbelievably was able to urinate within just a few seconds.  When I came out, the phlebotomist asked me if I had given her a specimen and I gladly said "Yep!"  She looked at me and said, "You got it going on!"  With that I wished her Merry Christmas and was on my way.  My next step was surgery.
    I was scheduled for a 1:00 p.m. surgery so I arrived at the designated time of 10:00 a.m.  Honestly, I wasn't nervous.  I was ready to go and get things underway.  When I finally got to pre-op and changed to my surgical gown, the nurse, Greta, went over all my paperwork with me.  She was as sweet as she could be but in two minutes she was asking me about the amoxicillin I was taking.  I couldn't help but laugh.  We got through everything then she brought my wife back and one of my co-workers that had stopped by to visit.  He had brought a plastic knife and offered to shave me.  We talked for a little while and before long it was time to move down the line a little farther and meet with my circulator nurse, Denise.  She was nice, friendly and had a sweet smile that was very reassuring.  We got an IV going and I made her promise that all my parts would be accounted for and make it to pathology.  One of my biggest fears was to go through all this and have someone lose all the tissue removed, never knowing how far the cancer had spread.  She promised it would all get to pathology.
    Next came my anesthesiologist and his assistant/intern.  I don't remember his name because he was Serbian and it was too difficult to pronounce, but his assistant was Kelly.  Kelly looked to be about 18 years old.  I'm sure she was older, but she had an extremely youthful appearance.  Then came a third anesthesiologist.  I haven't the slightest idea what his name was, but he apparently thought the guise of being dark and brooding would come off well.  It didn't.  He seemed to be little more than an asshole.  Considering he was in charge of gas, perhaps that was intended.
    My doctor stopped by and we discussed what was going to take place and a few other things.  I was glad to see that my circulator had worked with him many times and had nothing but praise for him.  He left shortly and, once more, I went over all the same personal information with the circulator that I had with Greta.  This time, Denise said it was a good idea to take the amoxicillin because "you don't want an anesthesiologist stopping the surgery because of some sinus infection."  Finally, I was vindicated!  I kissed my wife good-bye and remember nothing else.
    I awoke in a room alone.  I raised my gown and looked down to see a hairless lower torso with an incision about 9 inches long running from my naval to my pubic bone.  To the left of my naval three or four inches was a drain tube with a vacuum bulb to help pull out the juices.   Of course I was outfitted with a catheter.  This was the beginning of my recuperation.  I'll tell you about that next time.