Hello and welcome to the blog. You may have noticed that all of these episodes run between 10-15 minutes reading time. Yeah that’s by design. This topic can get pretty heavy for some people that’s why I made these short. You can click it off at one or two episodes or read to the whole story in one sitting. Hopefully I don’t get you too depressed reading these. I did try keeping myself positive during this period and tried desperately to keep my sense of humor which at time wasn’t easy.
I ended the last blog again in the watchful waiting period. It was at this time that Dr A1 made a speedy exit into retirement. Back to the drawing board, I now have Dr A2 who again was a well-established and very experienced Urologist. So here we go again, more PSA tests for a baseline with him and again the visit from the Fickle Finger of Doom. Once more I get the “Hmmmmm” when feeling my prostate.
I should probably give you some idea of a timeline right now so that you don’t think all of this is happening over months, quite the opposite this all up until now is happening over a period of six years. My PSA tests are running about a year apart at this point. They will increase to every six months in the future.
Well two years after my original biopsy my PSA numbers are rising again, this time up close to 5.0. Because of the shape of the prostate Dr. A2 elects to do another biopsy just to see if anything had changed. This was kind of the same deal as Dr. A1, just him and his nurse in his office. One big difference though was he prescribed a couple of pills prior to the procedure “to take the edge off”. Yeah man! Boy did it take the edge off. I didn’t have a care in the world! We were done in the blink of an eye, no bleeding penis this time. Not too bad at all. I did have my wife drive me home that time and again spent the day watching TV, drinking fluids, going to the bathroom and sleeping. The passing of the blood this time was much less than the first time.
A few days later I got the call, the biopsies came back clean, no cancer detected. Still with the rising PSA and additional flow concerns Dr A2 elected to put me on another medication Finasteride otherwise known as Proscar or Propecia, yes it’s the same drug given to guys with thinning hair.
So here’s the deal, we need another chalk talk….. As was explained to me I was given the drug to increase my urine flow, and to lower stabilize my PSA. The drug did lower my PSA but not by a ton. In many cases it can cut your PSA number in half. But that’s an issue guys. You can get lulled into a false sense of security with the low PSA number, things may be going on and ignored just because the PSA number is low.
So what is a good PSA number anyway….For men in their 40s and 50s: A PSA score greater than 2.5 ng/ml is considered abnormal. The median PSA for this age range is 0.6 to 0.7. For men in their 60s: A PSA score greater than 4.0 is considered abnormal. The normal range is between 1.0 and 1.5. At this point My PSA is over 5.0.
As I said when you go on this drug keep in mind your real PSA number is higher how high?
According to Johns Hopkins….
If you are taking finasteride, and you have been taking the drug for:
Two years: Multiply your PSA by 2
Between two and seven years: Multiply your PSA by 2.3
More than seven years: Multiply your PSA by 2.5
If your PSA begins to rise, get a biopsy immediately.
Ok, enough Chalk Talk.
I went onto Finasteride and I was on the drug for four years and yes, my PSA did begin to rise.
Well in a relatively short period of time Dr A2 also decides to retire. This leaves me with a dilemma, do I keep seeking out the experienced urologists who I figure are all going to retire on me or do I find a younger doctor who is more schooled on the newer technology in treating prostate issues. I chose the latter and my search brought me to Dr. D.
I like Dr. D a lot. Very serious guy but if you worked at it you could get him to smile on occasion. Not often but not impossible. By the end of 2015 I had my second biopsy which was clean. My PSA on Finasteride was 4.63. So do the math from the table provided…my real number was up around 9.0. Now just because you have high PSA it does not necessarily mean you have cancer. It’s an indicator, this is why we’re doing the biopsies, to rule out the cancer.
From the beginning of 2015 to the end of 2015 my number increased from 4.63 to 4.96. In 2017 my number stayed pretty flat 4.69 and 4.72. By June 2017 though the number had hit 5.24. The number without the Finasteride is more like 12.05 at that point. Oh crap. We waited a few more months and tested again in December 2017 and then number dropped to 4.71. Whew, I thought back in line then in Late March 2018 we tested again….5.20. Enough.
It’s been three years since my last biopsy and Dr. D wanted to biopsy the prostate himself except his approach was completely different. Enter the age of technology. As I mentioned I wanted a doctor who was more comfortable using all the technology available to him and boy did I get it.
Dr, D explained that this biopsy would be different, first they would take a MRI of the area for mapping then during the biopsy they would use Ultra Sound and overlay the images to the MRI and then he can pinpoint exactly where to take the biopsy samples. Makes sense to me. Lets do it.
First things first, the MRI. I’ve never had one before. I hear they can be loud, claustrophobic which makes some people freak out. My sister in law couldn’t do it….she freaked. And they can take quite a bit of time.
For me the worst part of the MRI was the prep, your bowels had to be clean. I mean really clean… I mean enema clean. Now my wife and I at this point are married 34 years but apparently this is the exact line in the sand for her that she refused to cross. Nope, not doing it, figure it out for yourself.
At this point I need to bring an important character into this story and his name is Scooter. Scooter is my dog, he’s a Beagle/Bassett Hound Mix and he loves me! We adopted him back in 2008 just as I was coming off the road and starting my new job. He chose me as a puppy and we are pretty much inseparable. If I was going out of town he would lay on the bed giving me those forlorn eyes of his as if to say please don’t go. This is a dog you can spend a day watching football with and he will not leave your side, no matter how much yelling you do at the TV. If I fell asleep on the couch at night he’d stand in the room with his laser eyes that would burn though my eyelids until I woke up and then we’d go to bed. Yes he slept on the bed.
Ok, back to the story. Enema time. So here I am in the master bathroom, down on the floor….In the downward dog position with the squeeze bottle. Scooter is sleeping on the bed…..or so I thought….I had the door open which was a big mistake…he sees me and now he thinks since I’m down on the floor it must be playtime! Lick, lick, lick…..go lay down…. Lick, lick, lick…..not now… Lick, lick, lick….. good dog. I need some privacy. Close they door. Finish the business.
I know some MRI’s use a coil that is inserted up your rectum but mine thankfully did not. For me the MRI itself was not a big deal. I had a 1-person tent back in boy scouts that I used on occasion and that was about as tight a fit as the MRI machine. So being claustrophobic was not an issue. The machine was loud but they gave me headphones and turned on music. I had to lay perfectly still and the table and blanket was warm…so….I fell asleep. They talk to you through the headphones telling you that they are now taking this image or that image and make sure you’re perfectly still. All told, it took maybe an hour to complete.
I did ask the MRI tech how many people panic inside the machine, he smiled and said about one a day, so that is a real thing for some people.
On to the biopsy, now each of the two previous biopsies I had done were in the Doctor’s office with only him and his nurse. This time I walk into the room and it’s full of people! Well not full, that’s an exaggeration but many more than the doctor and nurse. Now I’ll admit, this took me by surprise. I had always joked with the neighbors that I skinny dip in my pool out back after dark and if you don’t want to see it then don’t look in my direction. Well this time I was a bit taken aback. Ok, go on the room and put on your gown. You lay on the table as the doctor, nurses, technicians, bombadiers, navigators and flight attendants, the guy from food service, pretty much everyone in the building seemed to be in there doing something.
Just as before, I’m in my stylish gown, please get up on the table and lay on your right side. I then hear the doctor say….the first thing were going to do is insert the anal probe. I don’t know why but all of a sudden I blurted out “I didn’t like it the first time when the aliens did this! Laughter in the room during a prostate biopsy. The ultra sound navigator standing closest to me turned around and said “that was pretty funny, hadn’t heard that before”.
And then it started, conversations as to location between the Ultra sound Navigator and the Doctor, when the target was acquired….SNAP!…Snap! Snap! Snap! Snap! Many more than the first two previous biopsies. And then we were done. Now the waiting comes. The biopsy occurred on Thursday June 21st and the results didn’t come back until Tuesday June 26th at 3:30 in the afternoon…The phone rings….This is Dr. D’s nurse Mr Schmidt can you please verify your date of birth, which I did…..Mr. Schmidt please stay on the line for the doctor……Hello Mr Schmidt this is Dr. D, your biopsy results came back, I regret to inform you they came back positive for cancer…..All I heard was I have cancer.
Next time on Prostate Cancer Sucks, but there is always hope….You have cancer……one more reason to dislike Gleason…..and Joe Torre.
Prostate Cancer Sucks 