“Afternoon, Doc. What’s up?” I try to sound upbeat. It is April 2014. It has been three months since I have seen either Doc or Surgeon. In the meantime, I’ve had three routine BCG treatments but no lithotripsy treatments.
“Hello, Mr. New. How are you doing?”
We shake hands and Doc takes a seat, crosses his legs, and smiles at me.
“No pain from the stones?” he asks. “Your latest KUB (Kidney-Urethra-Bladder) images show no changes in the stone fragments. They’re right where we left them.”
I shrug my shoulders. “No pain. So, what do we do next?”
“Nothing, really. Since you are not having any problems from them, and we’ve cracked them twice, well, we’ll just leave them alone. However, we will monitor them every six months or so, just to keep an eye on them. How’s that sound?”
“Sounds great to me. X-rays don’t hurt. I like that idea.”
Doc chuckles. “Fine, then. Anything I need to know?”
I cock my head, thinking. “Well, last weekend, I did notice some blood in the urine again, but it didn’t show after the third day. I’m not sure if that means anything. It may not be another tumor. I may have just had my belt too tight.”
“Yeah, the dipstick report on the urine sample today did show a 2+ on the occult blood. However, that is Surgeon’s concern. I understand you have another Cystoscopy scheduled with him?”
“Yes,” I say, “Thursday, later this week.”
“Fine, then. I’ll schedule you for another KUB X-ray for six months out, in November. See you then.”
“Okay, Mr. New, looking good. Coming out.” Surgeon slip-slides out the camera probe. I’ve been propped, prepped, and now probed for Cystoscopy #6. Surgeon glances over at me after handing the camera/probe to his assistant. “I can’t say what, or where, the bleeding came from. You saw on the monitor, just as I did, that there were no recent hematomas, clot formations, or new tumors on your bladder wall.” Surgeon shrugged, and then smiled. “Perhaps you did have your belt on too tight!”
“So no major problems?”
“Major nor minor, Mr. New. I saw nothing. The BCG treatments look like they’re doing they’re job. Great, hunh?”
“Yeah, great,” I echo. I wonder what he’s not telling me. I’m still lying on the examination table. He has not told me to sit up yet.
“However, Mr. New, I checked your last PSA (Prostate Specific Antigen) results for the past two years. Both it and your Creatinine are trending high.”
“Yeah, my GP and I have been watching that. He says the slight increase in both may be from all of the manipulations from the BCG treatments and the Cysto exams. All that movement back and forth through the urethra could be stimulating the increase.”
“True, that could be all it is,” Surgeon nods. “However, it’s my job to make certain.” He snaps on another set of sterile gloves. Snap-snap. “I’m going to do a rectal exam. Just relax and keep breathing.”
Great. How far in is he going to go?
“Sterile gloves and some lubricating goo. A little pressure, Mr. New.”
Ummm. I feel something from below. Not sure what I feel. However, I’ll call it pressure.
“Okay, Mr. New. I’m through for today. You can sit up now.” He turns away and does something at a counter for a few minutes. “Well, that’s good, too. The Occult Blood test is negative. No rectal bleeding, Mr. New. Your prostate felt normal, too.”
“Oh, goody. That’s lovely.”
“Yes, it is. So, since that didn’t tell me anything new, I going to schedule you for a Prostate Exam/Biopsy in two weeks.”
“Oh, joy. What does that involve?” Do I really want to know? Well, yes.
“Not much, really. It’ll take only thirty minutes or so. I’ll apply some numbing jelly into your rectum. After it numbs you up, I’ll insert another probe, and then slide in a tool that can take a ‘grab’ of tissue cells. It will feel like you’re being pinched. I’ll take ten-to-twelve of these ‘pickings,’ as we call them, and that will be it. Then you can go. Oh, there may be some blood in the stool and in your ejaculate for two or three days. This is normal. It will clear up, never fear.”
“Two other things. I’ll prescribe you an antibiotic for this procedure. Take one pill the day before, the second the day of and the third pill the day after. You will need to buy an enema dose to take the morning of the procedure. Before you come in, that is. Your pharmacy will have one on the shelves. It’s an easy-peasy thing to do.”
Great! True Joy in the morning! “Thanks, Surgeon.”
Final Result: No tumors and no bleeding problems. However, there is the prostate gland to worry about—it’s always something, it seems.