Tuesday, 19 November 2013

It was at that point that I realised I should be nicer to the man about to stick 12 needles in my prostate

Look....I'm a large guy...fat even.
Okay....very fat even.

So my thyroid doesn't work properly and I take lots of thyroxine...lots.
And unless I eat less than 1000 calories a day, the weight just doesn't go away.
And I can't live any sort of reasonable life if it doesn't include  at least  a Kit Kat, a bacon roll and a slice of key-lime-pie a day.

So there I was a few months ago, at a Mens Health conference and one of the workshops  was on testosterone deficiency.
And I sat there listening to the eminent dokkie try and sell me some snake oil and did the little test and found that , according to the guest dokkie and his pharmaceutical sponsors, I was indeed "suffering" from a lack of testosterone.

I have noticed over the past few years that when I look at an attractive young woman,-indeed any woman really, of any age- , my only thought these days is , 'I wonder if she will make me a cup of tea?'
So perhaps my libido is lessening.

Anyway , when I was off with my cornea transplant I decided to have my testosterone levels checked...
...lo and behold, the level is way below the bottom of the normal range.
In fact I got a telephone call from the laboratory just to check that I wasn't a lesbian.
I assured them that when I had last checked, admittedly some time ago, I was still just a dirty old man.

But the private doctor I saw also wanted to check my PSA to make sure I wasn't going to run the risk of getting prostate cancer.
Now I don't intend to bore non-medical readers with all the ins-and-outs  - suffice it to say that the PSA is no longer considered to be a reliable test.
Except of course if you're a private doctor, not really willing to do anything except take money .
And of course unless you work for the NHS.
Now I accept the theory about looking at trends but really...three different doctors and one interesting young lady (who may not in fact have been medically qualified), have all felt my prostate and pronounced it normal.

So today I had a follow-up appointment and my PSA is trending upwards.

I started the day doing a flow rate test.This entailed drinking about 3 litres of water , juice , coffee and coke light and then urinating with as much force and gusto, whilst ideally properly aimed, into a funnel...which magically measured the force at which I pass urine.
Firstly, I passed 1,5 litters and the jug overflowed.
Secondly though, my flow rate is that of a horse.
Who knew?

Then I went to meet my surgeon for today.
(Note to foreign readers - you seldom get to see the same medical practitioner more than once, unless you are an "interesting case" ;and you never want to be considered "interesting")

Good morning...


So your PSA bloods are back and the value is not coming down...

"Uh huh...so what does that mean?"

Well what we would like to do is a procedure called a fine needle biopsy...


We will numb your prostate...


And then one of the nurse-specialists will insert 12 to 15 needles through your rectum and into your prostate and will take some samples...

"Look....dokkie...as keen as I am to extend my sexual repertoire the thought of 12 needles in my prostate doesn't sound like that much fun..."

Its very simple really...
Theres probably two being down right now somewhere in the clinic...
(That explained the screaming I heard on the way in then)
You might have some discomfort...
...and pass blood in your urine and your semen and your stool for a few days but its really very simple...

"Right...tell me...do you or your staff know how to operate the jaws-of-life?"

The Jaws-of-Life? I'm not sure I follow...?

"Well...and I say this with the greatest of respect... the only way you or your nurse is going to get me to open up my arsehole so you can stick me like a matador, is by using the jaws of life!"

Oh right...


Well we can give you a general anaesthetic and go in through your perineum if you'd prefer that?

"What about an MRI of the prostate? I'm happy to pay for it as a private patient."

Well its not necessarily that sensitive...

"I know...but a lot of the literature suggests that it is as sensitive as the needle biopsy..."

Well thats true...

"And if I have a choice between getting my gonads nuked or having some random needling done to my prostate, then I'll go for the nuking every time..."

Oh...okay...well its not something we do at this centre...we follow NHS guidelines...

Actually , said the nurse-specialist sitting next to the dokkie, we have an MRI list every monday that we never use...

Oh...well in that case, we can MRI you...and then if we see something we can do a specific needle biopsy...

"Marvellouso...well I'm  happy to pay for that..."

No, you won't have to pay...its all done on the NHS...

"Jah...but I've only lived here for a few years and don't really think the NHS should be paying for it...."

Well if we don't use the slots we lose them...

"Well...the slot is not actually lost is it? Its a potential urology slot that I'm sure gets taken up very quickly by one of the acute services..."

Well...we have the slot so we might as well use it...

Okay then.
I will.

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