ADVENTURES IN UROLOGY

I don’t often write here about what goes on in my off-line life, mainly because it is mostly routine day to day stuff and not much drama, but this is different, and, I have to admit, a bit out of my comfort zone.

It’s been an interesting few months on the medical front. I’ve been waiting to write about this until there was a clear plan to resolve the problem, which there now is.

Over the Labor Day weekend I thought I’d gotten severely constipated, even an intestinal block – bloated, feeling over full, very uncomfortable. I got in to see my GP that Tuesday (9/4). Her practice is part of the Mercy Hospital system based in Asheville, as is our local hospital. She sent me over to the hospital for blood work and a CT scan.

The diagnosis based on the symptoms and the CT scan done on 9/4 is Benign Prostate Hyperplasia (enlarged prostate). My prostate was (and as of now, still is) pushing up against my bladder and blocking normal flow out. My bladder was stretched to about three times normal size. Urinary catheter was placed on 9/4. I was given an appointment with the Urologist for the next day in Brevard, NC, which is about 40 miles away. A PSA (Prostate Specific Antigen) test and physical exam by the Urologist found no evidence of prostate cancer. He prescribed medication, Tamsulosin (generic for Flomax) to try to relax the prostate.

Probably unrelated, the week after that, I had some swelling from fluid buildup (Edema) in my right foot. There had been some in both feet before the catheter went in, but that resolved by the next day. So, I told the doctor and she sent be for an immediate ultrasound of that leg to check for Deep Vein Thrombosis. The result was negative, no blood clots found. The swelling went away by keeping the foot elevated at night for a week, but the cause remains a mystery.

There were several followup visits to the Urologist to do “Fill and Pull” tests. That is filling the bladder via the catheter and then removing the catheter to test ability to urinate. Results were negative. Medication was not solving the problem.

Further testing was ordered and done on 10/22. First there was a Cystoscopy, actually looking at the inside of the bladder with a fiber optic device. My bladder looked good except for the distortion caused by the prostate. Then came the Urodynamic test filling up the bladder with a catheter and measuring the pressure the bladder exerted. The result of that was good too.

The conclusion was that I would need surgery to reduce the size of the prostate and clear the passage out of the bladder. The procedure planned is “Green Light Laser PVP”. That uses a fiber optic tool like the Cytoscope with a laser going through it to burn away the excess tissue, a tiny bit at a time. That is currently scheduled as outpatient for Monday, 12/3 at the hospital in Brevard, with followup at Highlands on Thursday, 12/6.

Post-Op instructions are: No driving, vigorous exercise, climbing stairs, or lifting more than 5 pounds for at least one week. Instructions beyond that to be determined. I’m getting set up to stay on the first floor for however long and be stocked up on groceries and such for at least two weeks so that I don’t have to worry about getting rides to the store. I have arranged rides to Brevard for the surgery and to the office in Highlands (at the hospital complex) for the followup. I should hear next week about any pre- and post-op medications.

How am I doing with all this? In some degree, I’m paying the price of avoiding routine prostate exams, which should have allowed some earlier intervention, though I don’t know what or when that would have been, and also not recognizing the symptoms when they began. It sneaked up on me. Advice for men of a certain age – Don’t skip those exams.

As for the surgery, I’m both anxious about it and looking forward to being done with dealing with the catheter bags and back to peeing in the natural way, and not having things periodically stuck up my urinary tract. I’m also glad to be getting this taken care of before certain people in Washington get around to trying to mess with my Medicare. The Democrats taking over the House of Representatives majority is a relief in that regard too.

Having to ask for help with the transportation by putting the call out on the email lists of a couple of local groups I belong to wasn’t easy (even more out of the usual comfort zone), but several people came through right away.

So, since the surgery trip and procedure on Monday, December 3rd is going to be an all day affair, I will be pretty much absent from the cyberverse that day, but I’ll try to check in in the evening if I’m not too loopy from the anesthesia and likely pain meds.

Here are some links to information on the diagnosis, tests, and surgery method if you are interested in the details of those things.

https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087

https://www.mayoclinic.org/tests-procedures/cystoscopy/about/pac-20393694

https://en.wikipedia.org/wiki/Urodynamic_testing

https://www.roboticoncology.com/greenlight-laser/

http://www.bostonscientific.com/content/gwc/en-US/patients/health-conditions/enlarged-prostate/our-treatments/greenLight-laser-therapy.html

https://www.bostonscientific.com/content/dam/bostonscientific/uro-wh/general/ams/Resources/URO-429109-AA%20GL%20Patient%20Brochure_final.pdf

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4 thoughts on “ADVENTURES IN UROLOGY

  1. Oh, I’m so sorry you have to go through that. How stoic you seem! I really freaked out with a bladder ‘inspection’ and you sound so calm. The joys of aging, right? Really glad it’s not malignant.

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    1. The stoic part is an illusion, at least it certainly was when the insertions were happening and the nurse was saying, “I’m sorry, we’re almost there.” It helps that all the medical people with whom I’ve been dealing are very nice and competent. Maybe it helps that I never expected getting old to be easy. Besides, I’ve never known a bad attitude to improve any situation, so I just roll with it.

      Liked by 1 person

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